Explantation of an Infected Fenestrated Abdominal Endograft with Autologous Venous Reconstruction

Infectious complications after FEVAR cause significant problems, with radical surgery considered to be the last resort for treatment. A 72 year old man presented with infection 1 month after FEVAR. Conservative therapy with percutaneous abscess drainage and antibiotics suppressed the infection for 10 months; however, when new peri-aortic abscesses developed, the patient agreed to revision surgery. The endograft was explanted and an autologous in situ venous reconstruction was performed. As a result of post-operative complications, the patient died 3 days later. This study demonstrates that autologous venous reconstruction is technically feasible. An earlier decision on such radical surgery could potentially have improved the patient's chances of survival. •Infection of a fenestrated abdominal endograft causes a major problem with high morbidity and mortality rates.•Explantation of the endograft with autologous venous reconstruction is technically feasible.•Earlier decision for radical surgery could potentially improve survival rates.