Therapeutic opinion on endovascular repair for mycotic aortic aneurysm

Yao Kuang Huang, Po Jen Ko, Chyi Liang Chen, Feng Chun Tsai, Chi Hsiung Wu, Pyng Jing NLi, Cheng Hsun Chiu

研究成果: 雜誌貢獻文章

9 引文 斯高帕斯(Scopus)

摘要

Background: Our aim in this study was to assess the feasibility of endovascular repair for mycotic aortic aneurysms (MAAs) and to provide a therapeutic opinion. Methods: We retrospectively reviewed the records of 12 patients who underwent endovascular repair for MAAs between September 2006 and June 2011. Results: Patients consisted of 9 men and 3 women, with a median age of 64.6 years (range 45-75 years). The aortic aneurysms were in the thoracic/thoracoabdominal aorta in 5 patients, juxtarenal aorta with visceral involvement in 2 patients, and infrarenal abdominal aorta in 5 patients. Blood cultures of 10 patients (83.3%) were positive for bacteria and showed Salmonella species (8 patients), Klebsiella pneumonia (1 patient), and Escherichia coli (1 patients). Eight patients with active sepsis or active bleeding underwent emergent endovascular repair because of unstable hemodynamics. Notably, 2 patients required adjuvant surgery for complete removal of infectious foci. No deaths occurred within 30 days after intervention. We recorded 2 late deaths: 1 patient died of progressive pneumonia on day 39 after intervention and the other died of liver failure on day 58 after intervention. Late complications were observed in 3 patients, 1 of whom needed an aortic revision for late prosthesis infection. The mean follow-up time was 24 ± 19.7 months. Conclusions: Endovascular repair is a feasible therapeutic option for MAAs in that it can both stop bleeding and exclude the aneurysms. Although the aortic interventions performed were successful, the patients had an immunocompromised status and a difficult postoperative recovery. "Aggressive" surgical drainage may be necessary in some patients and may lead to a better outcome.

原文英語
頁(從 - 到)579-589
頁數11
期刊Annals of Vascular Surgery
28
發行號3
DOIs
出版狀態已發佈 - 2014

    指紋

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

引用此

Huang, Y. K., Ko, P. J., Chen, C. L., Tsai, F. C., Wu, C. H., NLi, P. J., & Chiu, C. H. (2014). Therapeutic opinion on endovascular repair for mycotic aortic aneurysm. Annals of Vascular Surgery, 28(3), 579-589. https://doi.org/10.1016/j.avsg.2013.07.009