Usatii Anatolie, Payne William, Santilli Steven
Department of Surgery, University of Minnesota and Minneapolis Veterans Healthcare System, Minneapolis, MN 55455, USA.
Ann Vasc Surg. 2013 Jul;27(5):679-83. doi: 10.1016/j.avsg.2012.09.007. Epub 2013 Mar 25.
Infection of an aortic endoprosthesis is a potentially lethal complication of an endovascular abdominal aortic aneurysm repair (EVAR). Surgical treatment usually involves excision of the infected endograft and vascular reconstruction, either in-line or extraanatomic. We present a case of severe infection of an endograft with suprarenal fixation. The one-stage procedure describes an in-line aortic reconstruction using a hybrid allograft composed of cryopreserved segments of cadaveric thoracic aorta and superficial femoral vein. A novel device for the removal of suprarenal fixating struts is described, as well as other technical maneuvers related to the removal of the struts used by surgeons in the community. The technique and surgical approach should be individualized based on patient characteristics, preoperative imaging, and knowledge of endograft construction.
主动脉内植入物感染是血管内腹主动脉瘤修复术（EVAR）的一种潜在致命并发症。手术治疗通常包括切除受感染的血管内移植物并进行血管重建，可采用原位或解剖外方式。我们报告一例带肾上固定的血管内移植物严重感染病例。一期手术描述了使用由尸体胸主动脉冷冻保存段和股浅静脉组成的混合移植物进行原位主动脉重建。介绍了一种用于移除肾上固定支柱的新型装置，以及社区外科医生在移除支柱时所采用的其他技术操作。该技术和手术方法应根据患者特征、术前影像学检查以及对血管内移植物构造的了解进行个体化选择。
