In Patients With Aortic Graft Infections, Does Evar Improve Long Term Survival Compared To Open Graft Resection?

Primary and secondary aortic infections are uncommon but potentially lethal conditions. It remains uncertain what treatment strategy is best for these patients. This chapter provides an overview of the current literature on different treatment options for primary and secondary infected aortas. No randomized controlled trials have been published and the highest levels of evidence are systematic reviews, retrospective cohort studies and case series. Mortality rates for open and endovascular repair are high (20-50%) and both show high reinfection rates (20%). In aortic graft infections, endovascular repair is mostly studied for the treatment of aortoenteric fistulas and seems feasible as a bridge to open surgery or as a definite treatment. In-situ repair has a slightly better outcome in most studies when compared with other open treatment options. No studies compared open with endovascular treatment. Therefore, from the current literature, no recommendations can be made and the best approach should be to weigh the pros and cons of open and endovascular treatment for each individual patient.