Endovascular Aneurysm Sealing (EVAS) in Combination with the Chimney Technique for the Treatment of Aortic Allograft Rupture

We report on a 62-year old male patient with complicated surgical history and actual covered ruptures of an aortic allograft. Considering the hostile abdomen we decided for an interventional/endovascular treatment. We implanted an aortic-(EVAS; Nellix®) as well as two renal stentgrafts in „chimney “technique. Following an uneventful perioperative course the patient was discharged on 14th postoperative day. This unusual case demonstrates that endovascular aneurysm sealing especially in combination with the chimney technique may be a feasible and reasonable alternative approach for the urgent/emergent treatment of aortic (prosthesis) associated complications where traditional surgical approaches are not applicable.

[1]  D. Böckler,et al.  Global Experience With the Nellix Endosystem for Ruptured and Symptomatic Abdominal Aortic Aneurysms , 2016, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[2]  O. Martinelli,et al.  Treatment of a Juxtarenal Aneurysm with a Parallel Graft in the Left Renal Artery and Polymer-Based Technology to Seal the Entire Aneurysmal Sac. , 2015, Annals of vascular surgery.

[3]  N. Osada,et al.  The role of open and endovascular treatment with fenestrated and chimney endografts for patients with juxtarenal aortic aneurysms. , 2012, Journal of vascular surgery.

[4]  A. Haverich,et al.  Eight-year experience with cryopreserved arterial homografts for the in situ reconstruction of abdominal aortic infections. , 2010, Journal of vascular surgery.

[5]  C. Kan,et al.  Outcome after endovascular stent graft treatment for mycotic aortic aneurysm: a systematic review. , 2007, Journal of vascular surgery.

[6]  Peter Andrew,et al.  A systematic review and meta-analysis of treatments for aortic graft infection. , 2006, Journal of vascular surgery.

[7]  C. Edmiston,et al.  Operative Strategies in Aortic Graft Infections: Is Complete Graft Excision Always Necessary? , 2005, Annals of vascular surgery.

[8]  F. Veith,et al.  Intra-abdominal aortic graft infection: complete or partial graft preservation in patients at very high risk. , 2003, Journal of vascular surgery.

[9]  R. Chalmers,et al.  Conservative Management of MRSA Periaortic Graft Abscess , 2003, Annals of vascular surgery.

[10]  V. Loo,et al.  Aortitis due to Salmonella: report of 10 cases and comprehensive review of the literature. , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  F. Veith,et al.  Diagnosis and management of infected prosthetic aortic grafts. , 1991, Surgery.

[12]  M. Kawashima,et al.  The treatment of pyogenic bone and joint infections by closed irrigation-suction. , 1980, Clinical orthopaedics and related research.

[13]  J. Deweese,et al.  Infected arterial grafts. , 1975, Annals of surgery.

[14]  W. Moore,et al.  Infection in vascular prostheses. Clinical manifestations and surgical management. , 1974, American journal of surgery.