Current Features of Aortic Graft and Endograft Infections: A Single-Centre Study of 37 Patients on the Effects of Medical and Surgical Treatment

Objectives: To assess whether outcomes differ in patients with aortic graft and endograft infections (AGEIs) according to therapeutic approach (medical treatment alone versus combined medical and surgical treatment) and to describe in detail the radiological and microbiological features of these infections. Methods: This was a single-centre, observational, retrospective study including patients admitted to Monaldi Hospital, Naples, Italy, with a diagnosis of AGEI between 2005 and 2025. All patients fulfilled MAGIC criteria for definite or suspected AGEI. Results: During the study period, 37 patients were enrolled. According to MAGIC criteria, 25 patients had a definite AGEI, while 12 met criteria for suspected infection. A microbiological diagnosis was obtained in 31 patients (84%), mainly from blood cultures (68%). Medical treatment alone was chosen for 19 patients (51%), whereas 18 patients received combined medical and surgical treatment. Crude 30-day, 90-day and 1-year mortality estimates were similar between treatment groups, whereas crude 3-year mortality was numerically higher in patients receiving medical treatment alone. Kaplan–Meier analysis showed a non-significant difference in survival according to treatment strategy (log-rank p = 0.160). Conclusions: AGEIs remain a severe and often fatal complication. In this small retrospective cohort, no statistically significant survival difference was observed between treatment strategies, although a clinically meaningful benefit of surgery cannot be excluded. Graft location was associated with distinct microbiological patterns and may help guide empirical antimicrobial therapy.