Endovascular grafting of traumatic aortic aneurysms in contaminated fields

Purpose: To evaluate the potential of endovascular stent-grafts to treat tr aumatic aortic lesions in contaminated areas. Methods: Four patients (3 women; ages 26-78 years) underwent stent-grafting to repair an aortic rupture sustained in a motorcycle accident, aortic lac erations secondary to surgical treatment of spondylitis in 2 patients, and an aortobronchial fistula following surgical thoracic aortic repair 10 year s earlier. Stent-grafts (2 Corvita, 1 Talent, and 1 Vanguard) were placed e ndoluminally into the infected areas via a transfemoral approach. Follow-up included erythrocyte sedimentation rate, white blood count, C-reactive pro tein, blood cultures, and computed tomography (CT). Results: The stent-grafts were successfully placed in all cases and exclude d the aortic lesion. Under supportive antibiotic therapy, inflammation para meters returned to normal. CT imaging showed no evidence of paraprosthetic infection, nor were there any other complications over a follow-up that ran ged from 3 to 34 months. Conclusions: Endovascular therapy may be an alternative in the acute manage ment of aortic ruptures in the setting of infection. Long-term results are required for definitive evaluation of the method.