Endovascular management of infected iliofemoral pseudoaneurysms - a systematic review

Vasa. 2017 Jan;46(1):5-9. doi: 10.1024/0301-1526/a000572. Epub 2016 Dec 7.

Abstract

We conducted a systematic review regarding the efficacy and outcome of endovascular treatment of infected iliofemoral arterial pseudoaneurysms with covered stents. 35 cases were identified, including 5 own. 22 pseudoaneurysms were located in the femoral area and 13 in the iliac vessels. The most commonly reported complaints were pulsatile groin mass (40 %), sepsis (37.1 %), active bleeding (31.4 %), and groin infection with purulent discharge (17.1 %). S. aureus (65.7 %) and Streptococcus species (22.9 %) were the most common microbes isolated. Factors for the development of infected pseudoaneurysms were intravenous drug use (20 %), infection of anastomosis in bypass surgery (22.9 %), cancer (14.3 %), history of multiple hip operations (14.3 %), renal transplantation (2.9 %), and obesity (5.7 %). The most commonly used covered stents were Viabahn (22.9 %),Jostent (17.1 %), Fluency (14.3 %), and Wallgraft (14.3 %). In 15 cases, surgical debridement and/or drainage was also performed.The mean follow-up was 15.8 months. There were only 2 cases of stent graft thrombosis (5.7 %). 2 patients required an open vascular bypass procedure at a later stage. One death was attributed to procedure-related complications (2.9 %). The infection rate of the deployed stent graft in follow-up was 3.4 %. Endovascular exclusion of an infected pseudoaneurysm with primary stent grafting and drainage may be an option in high-risk patients. .

Keywords: Femoral artery; covered stent; endovascular; iliac; infected aneurysm; pseudoaneurysm.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aneurysm, False / diagnosis
  • Aneurysm, False / microbiology
  • Aneurysm, False / mortality
  • Aneurysm, False / surgery*
  • Aneurysm, Infected / diagnosis
  • Aneurysm, Infected / microbiology
  • Aneurysm, Infected / mortality
  • Aneurysm, Infected / surgery*
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Blood Vessel Prosthesis Implantation* / mortality
  • Debridement
  • Drainage
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Endovascular Procedures* / mortality
  • Femoral Artery / microbiology
  • Femoral Artery / surgery*
  • Graft Occlusion, Vascular / etiology
  • Humans
  • Iliac Aneurysm / diagnosis
  • Iliac Aneurysm / microbiology
  • Iliac Aneurysm / mortality
  • Iliac Aneurysm / surgery*
  • Prosthesis Design
  • Prosthesis-Related Infections / etiology
  • Risk Factors
  • Stents
  • Time Factors
  • Treatment Outcome