Aortic Extender Endograft to Treat Infected Pseudoaneurysm of Proximal Aortic Graft Anastomosis

A 74 year old man with a ruptured infected native aortic aneurysm underwent open surgical repair with a 16 x 8 mm aortobi-iliac silver coated graft (Maquet, Rastatt, Germany). Two months later he presented with sudden abdominal pain and fever. Urgent computed tomography angiography showed a pseudoaneurysm of the proximal anastomosis (A, circle). Emergency treatment with a Gore Conformable 23 mm x 4.5 cm Aortic Extender Endograft (W.L. Gore & Associates, Flagstaff, AZ, USA) was performed successfully. Blood cultures were positive for Staphylococcus aureus. Two weeks of intravenous cotrimoxazole therapy followed by one year of oral cotrimoxazole therapy was prescribed. Follow up at one (B) and six months showed no recurrent infection or sign of aorto-enteric fistula.