A Novel Treatment Strategy for Infected Abdominal Aortic Aneurysms

Infected abdominal aortic aneurysms are rare, but the symptoms are prone to become severe during the clinical course, and the prognosis is poor, with a high rate of rupture [1]. There are 2 objectives in the treatment of infected aortic aneurysms: prevention of aneurysm rup‐ ture and infection control. However, it is not easy to achieve both. No guideline has been established yet, and many issues such as diagnostic method, the method of administering antibiotics before and after operation, timing of the operation, and operative procedure re‐ main to be improved. Regarding operative procedures, approaches such as the use of a ri‐ fampicin-soaked prosthetic graft, covering the prosthetic graft with the greater omentum, and anatomical reconstruction have been reported in recent years [1]. Nevertheless, postop‐ erative infection control is never easy, and the treatment results of infected aneurysms are still unsatisfactory. Therefore, we have devised a treatment policy to control local infection in a stricter manner by introducing the pulse-irrigation method that uses a pulsatile irriga‐ tion device and a temporary abdominal wall closure method that uses the vacuum-assisted closure (VAC) technique in patients with strong intraperitoneal contamination in addition to conventional operative procedures. In this study, we retrospectively verified the usefulness of our unique treatment strategy featuring the addition of these 2 new ideas using the treat‐ ment results of infected abdominal aortic aneurysms from the past 10 years.