Suprarenal mycotic aortic aneurysm: Surgical management and follow-up

Infected atherosclerotic ulcer of the abdominal aorta as a cause of mycotic aneurysm treated by in-situ prosthetic graft reconstruction: Report of a case

“…4,10 Nevertheless, the patency rates for axillofemoral grafts are lower than those for insitu interposition grafts. Furthermore, because prosthetic grafts can become infected by becteremia, the placement of an extraanatomic bypass graft gives no guarantee against graft infection.…”

“…2 However, Bacteroides fragilis and Clostridium septicum aneurysm of the suprarenal aorta have also recently been reported, emphasizing the necessity of culturing for anaerobes in these patients. 5,10 According to literature on the surgical treatment of mycotic aneurysms, 2,3,7,8 two options have been proposed, namely, ligation of the affected artery with wide local debridement and extraanatomic revascularization, or debridement and in-situ grafting of the affected vessel with prosthetic material or autogenous tissue. In either case, all the macroscopically infected tissue of the aortic wall must be excised as widely as possible, after which microbiologic and microscopic examination of the excised tissue should be carried out.…”

Infected aneurysms of the suprarenal abdominal aorta

“…The clinical experience is obtained from case reports, small series, and literature review. [6][7][8][9][10][11][12][13][14] In situ prosthetic reconstruction, accompanied by thorough debridement, prolonged antibiotic therapy, and probably lifelong suppressive oral antibiotics, offers the best chance for survival. 10,12,13 The reported hospital mortality of open in situ repair is Ͻ20%.…”

“…10,12,13 The reported hospital mortality of open in situ repair is Ͻ20%. [6][7][8][9][10][11][12][13][14] Survival is poor in extra-anatomic reconstruction. 12 However, a review based on several case reports or literature review may, however, be subject to publication bias resulting in a falsely high survival rate.…”

“…There have been only sporadic case reports or small case series. [6][7][8][9][10][11][12][13][14] Infected aortic aneurysm is common in Taiwan and Hong Kong. [15][16][17][18][19][20][21][22] We have reported that with timely surgical intervention and prolonged intravenous antibiotic, surgery with in situ graft replacement provides a good outcome.…”