Primary infected, ruptured abdominal aortic aneurysms: what we learned in 10 years

Primary infected, ruptured aortic aneurysms remain a rare and challenging clinical problem. Surgical treatment includes a range of options such as extra-anatomic bypass grafting and debridement with secutive in situ graft placement with autologous, bovine, and prosthetic grafts. Recently, endovascular treatment for infected abdominal aortic aneurysms has been reported with acceptable short-term survival. However, conclusive evidence based on randomized data with regard to optimal treatment is unavailable. We present 3 patients with a primary infected, ruptured abdominal aortic aneurysm that was treated with in situ graft placement and long-term antibiotic therapy. Our results, combined with a review of the literature, support in situ grafting as the treatment of choice.