Management von Stentprotheseninfektionen nach EVAR und TEVAR

Eine Stentprotheseninfektion nach endovaskulärer Aneurysmaversorgung ist eine seltene, jedoch schwere Komplikation mit hoher Mortalität. Aufgrund der steigenden Anzahl von endovaskulären Eingriffen ist mit einer Zunahme von Stentprotheseninfektionen zu rechnen. Eine einheitliche Leitlinie zu Diagnostik und Therapie dieses Krankheitsbilds existiert nicht. Im vorliegenden Artikel wird ein Überblick über die Genese und Therapie von Stentprotheseninfekten anhand der aktuellen Literatur gegeben. Zusätzlich werden die Ergebnisse der im eigenen Zentrum behandelten Patienten präsentiert.

Kernaussagen

• Die Endograft-Infektion nach EVAR oder TEVAR ist ein komplexes Krankheitsbild, das Erfahrung im Umgang mit Prothesenmaterialien erfordert.

• Es sind hohe Anforderungen an das perioperative Umfeld notwendig.

• Die chirurgische Herdsanierung, der Prothesenersatz und die begleitende antibiotische Therapie sind entscheidend für das Langzeitergebnis nach Endostentinfektion.

• Eine konservative Therapie sollte nur bei chirurgisch nicht sanierbarem Fokus oder inoperablen Patienten durchgeführt werden.

• Die Therapie von Stentprotheseninfektionen sollte Zentren vorbehalten bleiben.

Schlüsselwörter

EVAR - TEVAR - Stentprotheseninfektion - septische Gefäßchirurgie

• Literatur

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