CORRECTION OF COMPLICATIONS AFTER STENT GRAFT IMPLANTATION: TWO APPROACHES TO THE CORRECTION OF ENDOLEAKS AND INFECTIONS USING HOMOGRAFTS

Highlights

This study makes a significant contribution to the field of endovascular treatment of aortic aneurysms by examining two approaches to managing complications such as endoleaks and stent graft infections. For the first time, the use of cryopreserved homografts for treating stent graft infections is presented, demonstrating a reduced risk of recurrent infection and improved long-term outcomes. The study highlights the importance of timely diagnosis and an individualized approach in addressing complications following stent graft implantation.

Abstract

Endovascular aortic repair (EVAR) using stent grafts has become the gold standard in the treatment of aortic aneurysms, significantly reducing surgical invasiveness. However, it may be associated with serious complications such as endoleaks and stent graft infections. This article presents two clinical cases. In the first case, a 55-year-old female patient developed a type I endoleak due to incomplete apposition of the stent graft to the aortic wall. Surgical correction was performed with resection of the affected segments and replacement of the aortic arch and its branches. In the second case, a 61-year-old male developed a stent graft infection following thoracic EVAR. The infected graft was explanted, and a cryopreserved homograft was implanted to reduce the risk of reinfection. Both patients had successful outcomes with an uncomplicated postoperative course. These cases illustrate the importance of timely diagnosis and a personalized approach to managing EVAR complications. The use of homografts in infected fields proved effective in preventing recurrent infection and improving long-term outcomes. Our experience supports the effectiveness of these surgical strategies in complex clinical scenarios requiring individualized treatment.

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