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Case Reports: Reminder of important clinical lesson
Presentation and management of delayed aortic endograft infection
  1. Ben Li1,
  2. Hooman Hennessey2,
  3. John Fenton3 and
  4. Mohammad Qadura1,4
  1. 1Division of Vascular Surgery, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
  2. 2Division of Vascular and Interventional Radiology, Health Sciences North, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
  3. 3Division of Vascular Surgery, Health Sciences North, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
  4. 4Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Mohammad Qadura; mohammad.qadura{at}utoronto.ca

Abstract

A man in his 60s who underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm 4 years ago presents with 1 week of abdominal pain, fever and leucocytosis. CT angiogram demonstrated an enlarged aneurysm sac with intraluminal gas and periaortic stranding consistent with infected EVAR. He was clinically unfit for an open surgical intervention due to his significant cardiac comorbidities, including hypertension, dyslipidaemia, type 2 diabetes, recent coronary artery bypass grafting and congestive heart failure secondary to ischaemic cardiomyopathy with an ejection fraction of 30%. Therefore, due to this significant surgical risk, he was treated with percutaneous drainage for the aortic collection and lifelong antibiotics. The patient is well 8 months following presentation with no signs of ongoing endograft infection, residual aneurysm sac enlargement, endoleak or haemodynamic instability.

  • Infectious diseases
  • Interventional radiology
  • Vascular surgery

https://doi.org/10.1136/bcr-2022-252924

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    Footnotes

    • Contributors BL, HH, JF and MQ: conceptualisation, methodology, validation, resources, data curation and writing—review and editing. HH and JF: clinical care. BL and HH: software and visualisation. BL, HH and MQ: formal analysis and investigation. BL: writing—original draft preparation. MQ: supervision and project administration. All authors read and agreed to the published version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.