Combined Treatment with Open and Endovascular Surgery of a Mycotic Abdominal Aortic Aneurysm

What to Do When Evidence is Lacking — Implications on Treatment of Aortic Ulcers, Pseudoaneurysms and Aorto-Enteric Fistulae

“…As tent graft can either bridge over from an emergent situation, giving time for optimizing the patient for antibiotic treatment, and to decide if open operation should be made electively or not. Combined endovascular and open treatment have been suggested (34)(35)(36), but also favourable results have been reported on exclusively endovascular treatment (37,38). The experience is limited but morea nd moree ndovascular cases are reported.…”

“…repair and asubstantial number of case reports with favourable outcome has made endovascular technique at reatment option (34)(35)(36)(37)(38). As tent graft can either bridge over from an emergent situation, giving time for optimizing the patient for antibiotic treatment, and to decide if open operation should be made electively or not.…”

Mycotic Aneurysm in the Aortoiliac Area – Current Options for Treatment

“…This should start before the operation and continue for at least 4-6 weeks. Some sources recommend up to 3-5 months of antibiotics [11,24,25]. In our cases, the treatment lasted 6 weeks.…”

“…In case of a large aneurysm or a less favorable location, we can consider implantation of a bifurcated stent-graft [23]. Or an aorto-uniiliac stent-graft, possibly with a coil-embolization of the dilated iliac arteries; and with implantation of a prosthetic femoral crossover bypass [9,15,24]. Besides both the surgical as well as the endovascular treatment there is an indication for antibiotic therapy.…”