Aortoenteric Fistula with Aortic Graft Infection - Reconstruction of the Abdominal Aorta Without a Graft: a Possible Approach in Selected Cases

1999 ◽  
Vol 165 (12) ◽  
pp. 1201-1202 ◽  
Author(s):  
Björn Jönsson, Tommy Skau, Fredri
Keyword(s):  
Abdominal Aorta ◽  
Graft Infection ◽  
Aortoenteric Fistula ◽  
Aortic Graft ◽  
Aortic Graft Infection

Branched Endovascular Aortic Plug in Patients With Infrarenal Aortic Graft Infection and Hostile Anatomy

2020 ◽  
Vol 27 (2) ◽  
pp. 328-333
Author(s):  
Hamid Gavali ◽  
Kevin Mani ◽  
Mia Furebring ◽  
John Mogensen ◽  
Anders Wanhainen
Keyword(s):  
Abdominal Aorta ◽  
Case Reports ◽  
Graft Infection ◽  
Aortic Graft ◽  
Compassionate Use ◽  
Custom Made ◽  
Aortic Graft Infection ◽  
Male Patients ◽  
Axillobifemoral Bypass

Purpose: To present a novel 4-branched endovascular aortic plug (BEVAP) for treatment of patients with infrarenal aortic graft infection. Case Reports: Two polymorbid male patients with aortic graft infections and an unsuturable diseased paravisceral aorta were treated under compassionate use with a custom-made stent-graft. The BEVAP is a factory-modified Zenith t-Branch thoracoabdominal endovascular graft with the distal tubular main graft portion removed, creating an aortic plug that excludes the abdominal aorta while maintaining perfusion to the visceral organs. The BEVAP device is deployed using a femoral approach, and the branches are accessed through an axillary approach. A standard axillobifemoral bypass is created to perfuse the lower body. One to 2 days later, the infected infrarenal graft is resected without the need of aortic clamping or closure of the aortic stump. The BEVAP device in these 2 cases resulted in thrombosis of the abdominal aorta and the infected graft prior to explantation. Conclusion: Using the BEVAP enables radical treatment of selected patients with hostile anatomy and infrarenal aortic graft infections who have an aneurysmal paravisceral aortic segment that prevents traditional radical surgical treatment with in situ reconstruction or extra-anatomical bypass.

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