Local Tissue Coverage for the Management of Exposed Endografts

Abstract

This case report describes the use of local tissue coverage for the treatment of surgically exposed endografts. In two cases, an endograft used for the treatment of a pseuodaneurysm was visualized through the arterial defect during open surgical evacuation of an abscess in one case and a sterile hematoma in the second case. Obtaining arterial control to remove the endograft was prohibitive owing to the anatomic location and extensive scarring and inflammation. The endografts were preserved and hemostasis was maintained by using a vein patch in one case and a local muscle flap in both cases. Both cases have had satisfactory short-term follow-up (4–12 months). An exposed endograft represents a rare and challenging problem. Local tissue coverage offers a feasible strategy for maintaining hemostasis and avoiding a potentially morbid surgical dissection. Although the short-term results of this approach have been encouraging, the long-term consequences remain unknown.