&lt;p&gt;Mycotic pseudoaneurysm in intravenous drug users: current insights&lt;/p&gt;

Stevenson, Richard P.; Tolias, Christos M.; Hussey, Keith; Kingsmore, David

doi:10.2147/rrcc.s161698

Cited by 7 publications

(13 citation statements)

References 33 publications

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“…There is no direct comparison conducted between the prognosis of nonurgent operations and urgent operations due to actual clinical practice and experimental design. Nevertheless, comparable results can still be speculated on several main factors, including mortality and the incidence of severe complications, such as ischemia aggravation, postoperative bleeding, reintervention, and amputation, when compared to previous reports [3,8,13,14] .…”

Section: On Practical Feasibility Of Urgent Operationsupporting

confidence: 56%

Surgical Treatment of Ruptured Infectious Femoral Pseudoaneurysms Caused By Intravenous Drug Abuse: A Nonemergent (Postponed) Operation Pattern May Be a Possible Alternative

Luo

et al. 2021

Preprint

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Objective: To evaluate the possibility of surgical treatment of ruptured infectious femoral pseudoaneurysms caused by intravenous drug abuse in a nonemergent operation pattern, with retrospective analysis of clinical data and experience at a single center.Methods: Clinical data of 85 consecutive patients presenting with groin area active or recent hemorrhage due to a ruptured infectious femoral artery pseudoaneurysm related to drug abuse who were treated in the First Hospital of Changsha, China, from July 2008 to June 2020 were collected and analyzed.Results: A total of 74.1% of patients presented with active hemorrhage, and 36.5% presented with significant hypotension at admission. The average interval between arrival and operation was 34.7±4.7 hours. Vital physiological parameters and overall situation improved significantly after sufficient preoperative preparation. Satisfactory hemostasis can be achieved by bandage compression or local skin suture. No case was transferred to urgent operation due to severe bleeding, and 1 postoperative death case was observed in the cohort. The main operative- and postoperative-related indicators were satisfactory and close to those in the emergent operation pattern.Conclusion: While emergent or urgent operation is the mainstream surgical treatment for ruptured infectious femoral pseudoaneurysms, nonemergent (postponed) operation with sufficient preoperative preparation might also be an acceptable and comparable choice in some cases.

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Section: On Practical Feasibility Of Urgent Operationsupporting

confidence: 56%

Surgical Treatment of Ruptured Infectious Femoral Pseudoaneurysms Caused By Intravenous Drug Abuse: A Nonemergent (Postponed) Operation Pattern May Be a Possible Alternative

Luo

et al. 2021

Preprint

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“…Continued extravasation and expansion of a pseudoaneurysm ultimately risks free rupture 9. The arterial wall in PWID can also be further compromised by the severity of surrounding infection present, as well as the caustic acidifying agents injected 9–12…”

Section: Introductionmentioning

confidence: 99%

“…Given the probable non-sterile injecting technique, this can lead to the formation of an intramural abscess/haematoma complex 8 9 13 14. Arterial pseudoaneurysms may also occur as a result of malignant local infective invasion with destruction of arterial integrity from perivascular soft tissue sepsis 9 10 12 13. A further aetiology is septic metastases, for example, from infective endocarditis 10 14.…”

Section: Introductionmentioning

confidence: 99%

Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol

et al. 2023

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IntroductionPeople who inject drugs are at risk of a range of injecting-related infections and injuries, which can threaten life and limb. In parallel to escalating rates of drug-related deaths seen in Scotland and the UK, there has also been an increase in hospital admissions for skin and soft tissue infections related to injecting drug use. One such injecting complication is the infected arterial pseudoaneurysm, which risks rupture and life-threatening haemorrhage. Surgical management options for the infected arterial pseudoaneurysm secondary to groin injecting drug use remain contentious, with some advocates for ligation and debridement alone, whilst others promote acute arterial reconstruction (suture or patch repair, bypass or, more recently, endovascular stent-graft placement). Rates of major lower limb amputations related to surgical management for this pathology vary in the literature. This review aims to evaluate the outcomes of arterial ligation alone compared with arterial reconstruction, including open and endovascular options, for the infected arterial pseudoaneurysm secondary to groin injecting drug use.Methods and analysisThe methods will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Three electronic databases will be searched and the resultant papers screened according to the study inclusion and exclusion criteria (detailed in the Population, Intervention, Comparison, Outcomes and Study design statement). Grey literature will be excluded. All papers at each stage will be screened by two independent authors, with disagreements arbitrated by a third. Papers will be subject to appropriate standardised quality assessments.Primary outcomeMajor lower limb amputation.Secondary outcomesReintervention rate, rebleeding rate, development of chronic limb-threatening ischaemia 30-day mortality and claudication.Ethics and disseminationThis is a systematic review based on previously conducted studies, therefore, no ethical approval is required. The results of this work will be published in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration numberCRD42022358209.

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“…A pseudoaneurysm (PsA) refers to a disruption in the arterial wall resulting in blood flow between the tunica media and tunica adventitia. They are referred to as PsAs as they do not contain all layers of the arterial wall, excluding the intima [1][2]. Aneurysms of all types receive the descriptor "mycotic" when they form secondary to an infection.…”

Section: Introductionmentioning

confidence: 99%

Endovascular Intervention of a Mycotic Pseudoaneurysm of Accessory Left Hepatic Artery Arising from the Left Gastric Artery Presenting Secondary to Clostridium difficile Colitis: A Case Report

Serena

Antypas

Malay

et al. 2020

Cureus

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<p>Mycotic pseudoaneurysm in intravenous drug users: current insights</p>

Cited by 7 publications

References 33 publications

Surgical Treatment of Ruptured Infectious Femoral Pseudoaneurysms Caused By Intravenous Drug Abuse: A Nonemergent (Postponed) Operation Pattern May Be a Possible Alternative

Surgical Treatment of Ruptured Infectious Femoral Pseudoaneurysms Caused By Intravenous Drug Abuse: A Nonemergent (Postponed) Operation Pattern May Be a Possible Alternative

Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol

Endovascular Intervention of a Mycotic Pseudoaneurysm of Accessory Left Hepatic Artery Arising from the Left Gastric Artery Presenting Secondary to Clostridium difficile Colitis: A Case Report

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