ABSTRACT The combination of vascular graft or endograft infection (VGEI) and aortic hereditary disease (AHD) is extremely rare and just as challenging. We report a 40-year-old man presenting with a ruptured saccular aortic isthmus aneurysm treated with TEVAR, complicated by VGEI with an aorto-bronchial fistula, and multiple pseudoaneurysms. Despite complete graft explantation, prolonged antibiotic therapy, and additional endovascular and open interventions, he developed recurrent pseudoaneurysms with ultimately a fatal outcome. Genetic testing revealed a pathogenic COL3A1 mutation consistent with vascular Ehlers–Danlos syndrome. This case illustrates the diagnostic and therapeutic dilemma at the intersection of infection and AHD, underscoring the need for multidisciplinary management in complex aortic pathology.
Riahi et al. (Sun,) studied this question.