Annals of vascular surgery
October 5, 2026 · via Europe PMC
Bridge Endovascular Aneurysm Repair Followed by Delayed Open Reconstruction for Infected Native Abdominal Aortic Aneurysm.
Kwak JW, Cho SB, Kim HK, Oh YJ, Jung CW, Jun H
AI summary — for doctors, generated from the abstract only
A staged approach of bridging EVAR, prolonged antibiotics, then delayed open reconstruction looks feasible for infected native aortic aneurysm, with good infection control in survivors.
What was studied
Retrospective single-center review of consecutive infected native abdominal aortic aneurysm patients (2020-2025); eight of nine had EVAR first, then graft explantation and open reconstruction after infection control.
Key findings
- Median interval from EVAR to reconstruction was 79.5 days.
- Seven had in situ prosthetic reconstruction and one with persistent infection had femoral vein reconstruction.
- Two of eight died; estimated survival was 87.5% at 1 year and 65.6% at 3 years.
- No recurrent infection or graft reintervention among survivors.
Clinical relevance
Offers a way to avoid emergent open surgery in physiologically unstable patients with infected aneurysms by buying time for infection control.
Who should care
Limitations
Only eight patients, retrospective, single center, descriptive with no comparison group; the abstract conclusion is cut off.
Consider bridge EVAR with prolonged antimicrobials in high-risk infected aneurysm patients, in experienced centers, recognizing the evidence is very limited.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
OBJECTIVES
Infected native abdominal aortic aneurysm (INAA) is a life-threatening condition for which emergency open repair may carry substantial physiologic risk. This study evaluated a staged strategy using endovascular aneurysm repair (EVAR) for initial aneurysm exclusion, followed by prolonged antimicrobial therapy and delayed definitive open reconstruction.
METHODS
We retrospectively reviewed consecutive patients with INAA treated at a single tertiary referral center between January 2020 and December 2025. Patients undergoing bridge EVAR followed by delayed EVAR explantation and open reconstruction after infection control were included. Clinical characteristics, operative details, postoperative complications, infection-related outcomes, and survival were assessed descriptively.
RESULTS
Nine patients were diagnosed with INAA, of whom eight underwent staged treatment. Mean age was 68.1 years, five patients (62.5%) were male, and blood cultures were positive in six (75.0%). The median interval from EVAR to definitive reconstruction was 79.5 days (range, 55-105 days). Seven patients underwent in situ prosthetic graft reconstruction after infection control; one patient with persistent infection underwent autologous femoral vein reconstruction. During a median follow-up of 20.5 months (range, 1-39 months), two patients died. Estimated overall survival was 87.5% at 1 year and 65.6% at 3 years. No recurrent infection, graft infection, or graft-related reintervention was observed among surviving patients.
CONCLUSIONS
In this small cohort managed with a staged institutional strategy, bridge EVAR followed by prolonged antimicrobial therapy and delayed open reconstruction was feasible and achieved durable infection control among survivors. This strategy may provide time for infection control and physiologic recovery before definitive reconstruction; larger comparative studies are required.
DOI
10.1016/j.avsg.2026.09.049
PMID
42833582
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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