Endovascular repair of mycotic aortic aneurysms

J Vasc Surg. 2009 Aug;50(2):269-74. doi: 10.1016/j.jvs.2009.01.001. Epub 2009 May 15.

Abstract

Purpose: We report our single-center experience of early and midterm outcome after endovascular repair of mycotic aortic aneurysms (MAA).

Methods: Case records were retrospectively reviewed of 11 patients who underwent endovascular repair of 13 MAAs between 2000 and 2007. The aneurysms were localized in the aortic arch in 1 patient, descending thoracic aorta in 4, suprarenal abdominal aorta in 3, and infrarenal abdominal aorta in 5.

Results: Mean follow-up was 27 months. A bleeding aortoesophageal fistula resulted in one in-hospital death <or=30 days. Three patients died later: one each of sepsis, stent migration that caused intestinal ischemia, and an unknown cause. Two patients had recurrent sepsis postoperatively but no vascular complications, two had elevated inflammatory markers during follow-up but were asymptomatic, and three patients had an uneventful follow-up.

Conclusions: Endovascular treatment for MAA was feasible, with acceptable perioperative mortality and midterm outcome in this single-center case series. Recurrent sepsis and late relapse with a second MAA occurred, indicating the need of long-term antibiotic therapy and follow-up, as well as the possible need for secondary open repair in selected cases. Further research is warranted to evaluate long-term outcome.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm, Infected / diagnostic imaging
  • Aneurysm, Infected / mortality
  • Aneurysm, Infected / surgery*
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / mortality
  • Aortic Aneurysm / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Recurrence
  • Registries
  • Survival Rate
  • Sweden / epidemiology
  • Tomography, X-Ray Computed
  • Treatment Outcome