Antibiotic prophylaxis of graft infection is required prior to bronchoscopy, gastrointestinal or genitourinary endoscopy, and any dental procedure that may lead to bleeding (Grade 1, Level A).
Generalized sepsis, groin drainage, pseudoaneurysm formation, or ill-defined pain after OSR or EVAR should prompt evaluation of graft infection (Grade 1, Level A).
GI bleeding after OSR or EVAR should prompt evaluation of an aortoenteric fistula (Grade 1, Level A).
Excision of all graft material along with aortic stump closure with an omental flap and extra-anatomic reconstruction is recommended for treatment of an infected graft in the presence of extensive contamination (Grade 1, Level A).
In situ reconstruction with deep femoro-popliteal vein after graft excision and debridement is a recommended option when contamination is limited (Grade 1, Level A).
In situ reconstruction with silver or antibiotic impregnated grafts, arterial homografts, or a PTFE graft may be considered in patients with an infected prosthesis and limited contamination (Grade 2, Level C).
Follow-up of patients after EVAR or open surgery should include a thorough lower extremity pulse exam or ABI (Grade 1, Level A).
New onset of lower extremity claudication, ischemia, or a reduction in ABI after OSR or EVAR should prompt an evaluation of graft limb occlusion (Grade 1, Level A).
Type I endoleaks should be treated (Grade 1, Level A).
Treatment is recommended for Type II endoleaks associated with AAA expansion (Grade 1, Level B).
Treatment may be considered for Type II endoleaks not associated with AAA enlargement (Grade 1, Level B).
Type III endoleaks should be treated (Grade 1, Level A).
Type IV endoleaks do not require treatment (Grade 1, Level B).
Conversion to OSR of an AAA is recommended if a Type I or III endoleak does not resolve with endovascular treatment (Grade 1, Level A).
Conversion to OSR of an AAA is recommended for a Type II endoleak in association with a large or expanding aneurysm that does not resolve with endovascular or laparoscopic treatment (Grade 1, Level A).
Conversion to OSR of an AAA is recommended for a Type II endoleak in association with a large or expanding aneurysm that does not resolve with endovascular or laparoscopic treatment (Grade 2, Level C).