Endoluminal Repair of a Contained Thoracic Aortic Rupture Due to Primary Staphylococcal Aortitis

AbstractWe report a case of primary infectious thoracic aortitis with contained rupture of the descending thoracic aorta caused by Staphylococcus aureus and successfully treated with a rifampicin-rinsed aortic stent graft

Interventional Removal of Intravascular Medical Devices: Methods and Technical Success

Purpose: Evaluation of the technical success rate and complications when retrieving dislocated intravascular foreign bodies. Material and Methods: Between 1999 and 2015 38 patients (21 female; 17 male; Age: 17 -92; Average 54.3 years) underwent an extraction of intravascular dislocated foreign bodies, which were not lost during a radiological intervention. The extracted material included 29 port catheters, 3 tips of tunneled dialysis catheters, 2 stents, 2 guide wires, 1 CVC tip and 1 AS occluder device. Various catheters for repositioning and extraction were used. The access was transarterial as well as transvenous. Technical success was defined as complete removal of the foreign body. Results: The technical success rate was 92.1 % (35 of 38). In 17 patients an additional catheter was necessary to reposition the foreign body in order to make it accessible for the extraction catheter. In one case a stent was relocated and remodeled within the patient and was not extracted. In another case we experienced a dislocation of a small fragment of the port catheter into the distal parts of the pulmonary artery, which couldn't be extracted. A guide wire could not be extracted as it was already adhered with the vessel wall. Peri-interventional complications were not documented. Conclusion: The percutaneous extraction of dislocated intravascular foreign bodies is technically successful and poor of complications. Interventional therapy can avoid surgical removal. Key points: The percutaneous extraction of dislocated intravascular foreign bodies is technically successful and safe. In most cases surgical removal can be avoided. The gooseneck-snare catheter was mainly used for the extraction of intravascular foreign bodies. Citation Format: Ayx I, Goessmann H, Hubauer H et al. Interventional Removal of Intravascular Medical Devices: Methods and Technical Success. Fortschr Rontgenstr 2016; 188: 566-57

Biosynthetic vascular graft: a valuable alternative to traditional replacement materials for treatment of prosthetic aortic graft infection?

Background and Aims: To report the experience of a tertiary vascular surgery center using Omniflow II (R) biosynthetic vascular grafts for treatment of prosthetic aortic graft infection. Materials and methods: Retrospective analysis of all patients with prosthetic graft infections who underwent in situ aortic reconstruction using Omniflow II (R) grafts or other conduits between March 2015 and May 2017. Early and late mortality, perioperative complications, and reinfection rate were analyzed. Results: Sixteen patients (14 males, median age 68.5, range 57-89) with prosthetic aortic graft infection were treated at our center. Eight patients received an Omniflow II (R) biosynthetic graft, two patients silver-triclosan coated grafts, three patients bovine pericardial tube grafts, and three patients composite bovine pericardial tube grafts with Omniflow II (R) graft extensions. Perioperative complications occurred in seven patients (43.8%). Early mortality rate was 18.7% (n = 3). In addition, four patients died during follow-up after a median of 11 months (range 0-34 months). We did not observe any reinfections. Bypass grafts were patent in all patients. No major limb amputations were performed during follow-up. Conclusion: Treatment of prosthetic aortic graft infection with Omniflow II (R) vascular grafts is feasible. Graft material seems to have an excellent resistance to infection and might be a valuable alternative to traditional replacement materials. Especially long-term durability has to be continuously monitored and documented