Mycotic aortic aneurysms and aortic graft infections : cryopreserved arterial allografts remain our first choice

Seance of wednesday 13 march 2024 (Chirurgie vasculaire de recours)

DOI number : 10.26299/pwwg-v419/emem.2024.09.04

Abstract

Graft infections complicate 1 to 6% of thoracic or abdominal aortic procedures. Primary infectious aortic aneurysms account for 1% of all aortic aneurysms. The associated mortality is significant. Optimal surgical management requires complete resection of the infected material, drainage of the infectious focus, and iterative in situ revascularization using a graft resistant to reinfection (preferably) or extra-anatomic revascularization. Various grafts have been proposed for in situ revascularization, including prostheses impregnated with antibiotics or silver salts, biological prostheses made from animal pericardium, autologous superficial femoral veins, and cryopreserved arterial allografts. Cryopreserved arterial allografts, applicable in both thoracic and abdominal areas, have demonstrated resistance to most microorganisms involved in aortic sepsis in both in vitro and in vivo models. Clinical studies also report favorable outcomes considering the severity of the pathology. They constitute our first-choice in both primary and prosthetic aortic infections.