Infected aneurysm of the thoracic aorta

Hsu, Ron‐Bin; Lin, Fang‐Yue

doi:10.1016/j.jvs.2007.10.017

Cited by 95 publications

(98 citation statements)

References 29 publications

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“…22 Non-Salmonella-positive blood culture was the main factor associated with serious late complications in the present report, an observation supported by previous smaller reports. 8,19,26,27 The duration and choice of ABx-therapy is an important matter for debate. Some authors recommend parenteral or oral ABx for at least 6 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…The difficulty in obtaining anaerobic cultures, and the fact that these patients often received early broad spectrum antibiotics, may explain the rate of positive cultures in the present report (67%), which is in line with previous reports on endovascular as well as on open repair. 6,7,27,28 Consequently, microbiological cultures (blood or aortic tissue) may turn out negative, despite a high clinical suspicion of a MAA. Adding to the complexity of this issue, routine culture of abdominal aortic aneurysm wall during open surgery of clinically noninfected patients has been found to be positive in ≈14% to 37% of the cases.…”

Section: Limitationsmentioning

confidence: 99%

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Endovascular Treatment of Mycotic Aortic Aneurysms

et al. 2014

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Background-Mycotic aortic aneurysm (MAA) is a rare and life-threatening disease. The aim of this European multicenter collaboration was to study the durability of endovascular aortic repair (EVAR) of MAA, by assessing late infectionrelated complications and long-term survival. Methods and Results-All EVAR treated MAAs, between 1999 and 2013 at 16 European centers, were retrospectively reviewed. One hundred twenty-three patients with 130 MAAs were identified. Mean age was 69 years (range 39-86), 87 (71%) were men, 58 (47%) had immunodeficiency, and 47 (38%) presented with rupture. Anatomic locations were ascending/arch (n=4), descending (n=34), paravisceral (n=15), infrarenal aorta (n=63), and multiple (n=7). Treatments were thoracic EVAR (n=43), fenestrated/branched EVAR (n=9), and infrarenal EVAR (n=71). Antibiotic was administered for mean 30 weeks. Mean follow-up was 35 months (range 1 week to 149 months). Six patients (5%) were converted to open repair during follow-up. Survival was 91% (95% confidence interval, 86% to 96%), 75% (67% to 83%), 55% (44% to 66%), and 41% (28% to 54%) after 1, 12, 60, and 120 months, respectively. Infection-related death occurred in 23 patients (19%), 9 after discontinuation of antibiotic treatment. A Cox regression analysis demonstrated non-Salmonellapositive culture as predictors for late infection-related death. Conclusions-Endovascular

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Endovascular Treatment of Mycotic Aortic Aneurysms

et al. 2014

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“…Several studies in Taiwan, including our institutional experience, have demonstrated a graft infection rate of 8.0-10.4% after in situ prosthetic graft replacement for infected aortic aneurysms [11,12,[113][114][115][116]118]. In a more recent study investigating the outcomes of open repair of infected descending thoracic and thoracoabdominal aortic aneurysms by Lau et al, no postoperative graft infection occurred in 14 patients who had in situ prosthetic graft reconstruction [77].…”

Section: Choice Of Graft Materials For In Situ Reconstructionmentioning

confidence: 87%

Infected Aortic Aneurysms

Lin¹,

Kan²

2017

Aortic Aneurysm

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Infected aortic aneurysms are surgical urgencies, requiring prompt management to avoid the development of catastrophic complications. Although traditional open surgery composed of radical debridement and aortic reconstruction remains the gold-standard, many favorable results of the endovascular repair strategy have been reported. In this chapter, the etiology, bacteriology, clinical manifestation, and diagnostic criteria of infected aortic aneurysms will be discussed in detail at first, followed by a comprehensive review of both traditional open surgery and endovascular repair, based on current evidences and the authors' institutional experience. Along with long-term oral antibiotic suppression and aggressive adjunctive procedures, endovascular repair for uncomplicated infected aortic aneurysms could be a definite treatment alternative to traditional open surgery in the endovascular era.

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“…When primary bacteremia is the cause, it most commonly originates from a distal infection in soft tissue or an infection in the lung, bone, or joint tissue. At the site of a preexisting aneurysm, the wall of the aorta is thinned and can be further weakened by focal acute and chronic inflammation; therefore, this site is as likely to develop into an infected pseudoaneurysm, as is its propensity to rupture (2)(3)(4)(5)(6)(7)10).…”

Section: Discussionmentioning

confidence: 99%

“…The mortality rate among patients with infected aortic aneurysms treated with antibiotics alone has been reported at 16% -44% (5,15). The critical points in the management of infected aortic aneurysm are the optimal timing of surgical procedure and the antibiotic strategy.…”

Section: Discussionmentioning

confidence: 99%

Rapidly Progressing Aneurysm of Infected Thoracic Aorta with Pseudoaneurysm Formation

et al. 2010

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A 60-year-old man presented with chest discomfort with fever and high C-reactive protein (CRP). Chest computed tomography (CT) disclosed a mediastinal soft tissue swelling originating from the aortic arch, and gallium-67 single-photon emission CT revealed intense uptake in the same region. We initially suspected mediastinitis and/or a thoracic aortic infection. Antibiotics improved his symptoms and CRP levels. However, a follow-up CT scan 33 days later, revealed an aortic arch aneurysm and the patient was diagnosed with infective aortic aneurysm. Here, we report a rare case of a rapidly progressing aneurysm of infected aorta aortic infection with pseudoaneurysm formation.

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Infected aneurysm of the thoracic aorta

Cited by 95 publications

References 29 publications

Endovascular Treatment of Mycotic Aortic Aneurysms

Endovascular Treatment of Mycotic Aortic Aneurysms

Infected Aortic Aneurysms

Rapidly Progressing Aneurysm of Infected Thoracic Aorta with Pseudoaneurysm Formation

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