关键词: 主动脉瘤腔内修复术, 主动脉移植物, 移植物感染, 影像学检查, 抗生素治疗, 手术治疗, 血管外科, 治疗方案

Abstract: Aortic endograft infection (AEI) is a rare but potentially fatal complication after endovascular aneurysm repair (EVAR). There is currently no large-scale prospective clinical study to determine the optimal treatment for AEI. Infection at any site may be the causative pathogen for AEI. The clinical manifestations of AEI range from asymptomatic, fatigue, fever, pain, weight loss, and gastrointestinal bleeding, to the most severe shock. The diagnosis of AEI requires a combination of multifaceted evidence, including clinical manifestations, imaging examinations, and laboratory test results. The most common diagnosis criteria are proposed by the Management of Aortic Graft Infection Collaboration (MAGIC). The preferred treatment for AEI is complete removal of the infected graft, followed by in situ aortic reconstruction or extra-anatomical bypass surgery, depending on the specific circumstances. For patients with a short life expectancy and high surgical risks, partial graft resection or conservative treatment (long-term anti-infection treatment with selected antibiotics based on culture results and drug sensitivity test results, supplemented by percutaneous drainage and antimicrobial solution irrigation of localized abscesses) can be considered. To effectively prevent AEI, appropriate patients for EVAR should be strictly selected, the principle of sterility should be followed during the procedure, and the re-intervention rate should be reduced.

Key words: endovascular aneurysm repair (EVAR), aortic endograft, graft infection, imaging examination, antibiotic therapy, surgical treatment, vascular surgery, treatment strategy