Dr.Yue Achieves China’s First NAIS( Neoaortoiliac System) for Infected Abdominal Aortic Aneurysm

In 2022.4, the Vascular Surgery team at Zhongshan Hospital, Fudan University, has successfully performed China’s first reconstruction of the abdominal aorta using the patient’s own deep veins to treat a severe infected abdominal aortic aneurysm, offering a new potential curative option for this life-threatening condition. 

The very 1st NAIS procedure was successfully performed in Zhongshan Hospital by Dr.Jianing Yue.

The 58-year-old patient had initially undergone emergency stent-graft implantation elsewhere for a rupturing infected aneurysm. However, the infection rapidly progressed despite antibiotic therapy, leading to severe graft and retroperitoneal infection. By the time he arrived at Zhongshan Hospital, he was critically ill with bacteremia, partial intestinal obstruction, severe malnutrition, and cachexia. 

Because conventional artificial grafts and stent-grafts are highly vulnerable to reinfection in this setting, the team determined that the infected endograft had to be removed. Given the patient’s condition, they ruled out standard extra-anatomic bypass and instead planned a highly complex in-situ reconstruction using autologous deep veins harvested from both thighs. 

On the third day after admission, the patient underwent the pioneering operation. Intraoperatively, surgeons found an aorto-colonic fistula, one of the most lethal forms of infected abdominal aortic aneurysm. Under the leadership of Professor Weiguo Fu, Dr. Yue's team removed the infected graft, resected the infected tissue, and reconstructed the abdominal aorta with a Y-shaped graft fashioned from the patient’s own femoral veins. The nine-hour procedure was completed with multidisciplinary support from general surgery, anesthesia, and perioperative nursing teams. 

After intensive postoperative care, the patient recovered without major complications such as graft rupture, compartment syndrome, or deep vein thrombosis. This landmark case marks the first reported use in China of autologous deep vein reconstruction for severe infected abdominal aortic aneurysm and may help shift treatment from palliative control toward definitive surgical cure.