Contemporary Results of Surgical Management of Peripheral Mycotic Aneurysms

Salzler, Gregory G.; Long, Becky; Avgerinos, Efthymios D.; Chaer, Rabih A.; Leers, Stephen; Hager, Eric; Makaroun, Michel S.; Eslami, Mohammad H.

doi:10.1016/j.avsg.2018.04.019

Cited by 14 publications

(9 citation statements)

References 12 publications

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“…Endocarditis has been implicated as the etiology in roughly 16% of the cases [5]. In Salzer's series of 28 peripheral aneurysms, the popliteal artery was the second most affected vessel and Staphylococcus epidermidis was seen in 7.7% of pathogens [6]. [10].…”

Section: Discussionmentioning

confidence: 99%

Mycotic Popliteal Artery Aneurysm With Rapid Enlargement Post-Bypass

Lajos

Bangiyev

Safir

et al. 2021

Cureus

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Popliteal artery aneurysms (PAAs) are the most common type of peripheral artery aneurysms. Mycotic aneurysms involving the popliteal artery are quite rare and can occur as either a primary de novo infection or a secondary infection from another site. To our knowledge, there are no previous case reports on mycotic PAA in which Staphylococcus epidermidis was the primary etiologic pathogen. We present the case of a 55year-old male who presented with complaints of lower extremity pain and swelling, malaise, and low-grade temperatures for two weeks and was found to have a PAA. He underwent left femoral-popliteal bypass grafting with expanded polytetrafluoroethylene (ePTFE) graft and ligation of the aneurysm. On postoperative day 10, he experienced acute swelling and pain in his lower extremity with foot drop and was found to have rapid enlargement of his aneurysm sac on imaging. He was returned to the operating room emergently where he underwent aneurysmectomy via a posterior fossa approach. Cultures and gram staining of the aneurysm sac were consistent with Staphylococcus epidermidis. As noted above, this case of mycotic PAA was treated with standard vascular surgical techniques, yet it proceeded to enlarge acutely. PAAs that rapidly expand or rupture after surgical interventions may be a sign of infection.

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Section: Discussionmentioning

confidence: 99%

Mycotic Popliteal Artery Aneurysm With Rapid Enlargement Post-Bypass

Lajos

Bangiyev

Safir

et al. 2021

Cureus

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“…1 Whereas Staphylococcus aureus and Salmonella spp are the bacteria most frequently associated with mycotic aneurysm, viridans streptococci are the most common bacteria involved in mycotic aneurysm in patients with concurrent bacterial endocarditis. [3][4][5] Management of mycotic aneurysm has traditionally been resection of the aneurysm and bypass to restore distal flow. DeBakey and Simone in 1946 demonstrated a high rate of limb amputation after mycotic aneurysm resection without revascularization; however, some authors advocate for selective revascularization.…”

Section: Discussionmentioning

confidence: 99%

“…DeBakey and Simone in 1946 demonstrated a high rate of limb amputation after mycotic aneurysm resection without revascularization; however, some authors advocate for selective revascularization. 3 Regardless of surgical approach, long-term antibiotics are considered a mainstay of treatment. A literature review recommended 6 weeks of antibiotic treatment for intracranial vascular mycotic aneurysm and selective intervention based on lack of response to antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…1 Left untreated, mycotic aneurysms can lead to rupture, embolization, limb loss, or death. 2,3 Traditional management has been ligation or resection with or without extra-anatomic bypass. 2,3 We present a case in which nonoperative management of a mycotic aneurysm led to complete resolution.…”

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confidence: 99%

See 2 more Smart Citations

Successful nonoperative management of mycotic radial artery pseudoaneurysm in patient with absent superficial palmar arch

Mahoney

Hagino

Masuda

2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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We present the case of a patient in whom a mycotic radial artery false aneurysm developed after removal of a radial arterial line; anatomic constraints precluded simple resection and ligation of the infected artery. The patient was successfully treated nonoperatively by compression bandaging, intravenous antifungals, and serial imaging. This case represents an alternative to standard management of a mycotic aneurysm and demonstrates the importance of an individualized approach to patient care.

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