Infected Aortic Aneurysms

Lin, Ting-Wei; Kan, Chung Dann

doi:10.5772/66417

Cited by 6 publications

(13 citation statements)

References 131 publications

(217 reference statements)

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“… 44 Moreover, several of these bacteria have been associated with the development of AD or AN. 45 Bacterial biofilm even has been supposed to be related to the formation of gallstones without symptoms and atherosclerosis. 46 The bacteriology was not available in our database, but cholecystectomy might eliminate the source of bacterial colonisation.…”

Section: Discussionmentioning

confidence: 99%

Risk of aortic dissection or aneurysm in patients with gallstone disease: a retrospective cohort study in Taiwan

2021

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ObjectiveThis nationwide population-based cohort study was to compare the risk of aortic dissection (AD) or aortic aneurysm (AN) between the subjects with and without gallstone disease (GD). We also compare the risk of AD/AN between the patients with GD with and without cholecystectomy.SettingThis nationwide population-based cohort study.ParticipantsWe extracted the hospitalisation database from the National Health Insurance Research Database of Taiwan and identified a total of 343 300 patients aged ≥20 years with GD newly diagnosed between 2000 and 2010 as the study cohort, including 191 111 with cholecystectomy and 152 189 without cholecystectomy, respectively. We randomly selected those without GD as the control cohort, by 1:1 propensity score matching with the study cohort based on age, sex, comorbidities and year of the index date for GD diagnosis.ResultsThe incidence of AD/AN was 6.65/10 000 person-years for the GD cohort and 6.24/10 000 person-years for the non-GD cohort (adjusted HR (aHR)=1.11, 95% CI=1.09 to 1.13), respectively (p<0.001). Furthermore, the incidence of AD/AN in the patients with GD was 9.93/10 000 person-years for the non-cholecystectomy patients (aHR=1.24, 95% CI=1.22 to 1.26) and 4.63/10 000 person-years for the cholecystectomy patients (aHR=0.97, 95% CI=0.95 to 0.99), respectively (p<0.05).ConclusionsThe GD cohort was associated with and greater risk of AD/AN than the non-GD cohort, but the risk of AD/AN in the patients with GD would decrease after cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Risk of aortic dissection or aneurysm in patients with gallstone disease: a retrospective cohort study in Taiwan

2021

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“…As bacterial presence is often difficult to establish, a common agreement exists to accept the diagnosis based on three criteria: clinical presentation (abdominal or back pain, fever, sepsis), laboratory results (elevated infection markers, positive blood and/or tissue samples), imaging studies (periaortic oedema, soft tissue mass, periaortic gas, saccular and eccentric or multilocular aneurysm), and may be supported by perioperative findings if managed with an open surgical approach (Fig. 1) [2 , 3,5,[9][10][11][12][13][14]. Frequently, INAA patients are smokers, present with concomitant infection and suffer malnutrition or immunosuppression [5,12,13,[15][16][17].…”

Section: Definition and Diagnostic Algorithm Of Infective Native Aort...mentioning

confidence: 99%

“…1) [2 , 3,5,[9][10][11][12][13][14]. Frequently, INAA patients are smokers, present with concomitant infection and suffer malnutrition or immunosuppression [5,12,13,[15][16][17].…”

Section: Definition and Diagnostic Algorithm Of Infective Native Aort...mentioning

confidence: 99%

Section: Definition and Diagnostic Algorithm Of Infective Native Aort...mentioning

confidence: 99%

“…The infection is predominantly caused by bacteria, but in rare cases also by fungi [6,12,18,19]. In Europe and Northern America, most common infective agents Staphylococci, Streptococci and Salmonella are represented more equally, while Eastern Asia is overwhelmingly dominated by Salmonella and followed by Staphylococci and Streptococci [5,6,12,13,19]. Microorganisms isolation from blood or tissue-samples is successful in 60-90% of the cases depending on antibiotic administration prior culture acquisition and the surgical treatment method used [5,[10][11][12][13][14][15][16]20].…”

Section: Definition and Diagnostic Algorithm Of Infective Native Aort...mentioning

confidence: 99%

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Contemporary management of infective native aortic aneurysms

Heinola

Sörelius

2021

Current Opinion in Cardiology

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Purpose of reviewInfective native aortic aneurysms (INAAs) are challenging and complex with both bacteraemia and an aneurysm prone to rupture. They are fatal unless recognized and treated promptly. The rarity of the disease makes it unfamiliar to most physicians, which might delay both diagnosis and treatment. The present review aims to outline the recently published diagnostic algorithm of INAAs, the main characteristics of the disease and present an overview of contemporary treatment strategies. Recent findingsNew terminology, definition, diagnostic algorithm and reporting standards have recently been proposed for INAAs. Current evidence concerning the treatment of INAAs is founded on retrospective register-based multicentre studies and small single-centre studies. Recent findings encourage the use of endovascular aortic repair (EVAR) for surgical treatment of INAAs. Although EVAR, as a surgical approach, does not drain the infection, the postoperative infection-related complication rates (IRCs) are similar to the ones reported after open surgical repair (OSR) with aortic prosthetic reconstruction and extensive debridement. IRCs carry over 50% risk of being fatal. Postoperative mortality after EVAR remains considerably lower supporting the use of method for aged and comorbid group of patients. Biological grafts have the benefit of being more resistant to reinfection. OSR with biological reconstruction is a promising surgical approach for patients fit for open surgery; however, data are scarce and long-term follow-up is lacking.

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A rare case of mycotic aortic aneurysm with Clostridium perfringens culture

Tadayon,

Shahsavari,

Yahya

et al. 2023

Clinical Case Reports

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Key Clinical MessageAs only early diagnosis, prompt surgical intervention, and appropriate antibiotic therapy can decrease clostridial MAA mortality rate; keeping in mind a broad differential diagnosis in a patient with sepsis and unusual vascular symptoms is important.AbstractMycotic aortic aneurysm (MAA) is an infrequent but very consequential condition characterized by the pathological disruption of the aorta due to infection. Clostridium perfringens is a bacterium that falls under the taxonomic classification of the genus Clostridium. Although mycotic aneurysm is often not commonly linked with this infection, there are instances when it may function as a causative agent for MAA. Timely diagnosis and thorough therapeutic techniques, including surgical intervention and quick administration of appropriate antibiotics, can potentially reduce the mortality rate associated with clostridial MAA. In this study, we presented a clinical report detailing the diagnosis of a mycotic aneurysm caused by C. perfringens in the thoracic aorta in a 66‐year‐old male patient with a history of diabetes mellitus and a recent prostate biopsy. Furthermore, we discussed the surgical approach and overall management strategy to address this case.

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Infected Aortic Aneurysms

Cited by 6 publications

References 131 publications

Risk of aortic dissection or aneurysm in patients with gallstone disease: a retrospective cohort study in Taiwan

Risk of aortic dissection or aneurysm in patients with gallstone disease: a retrospective cohort study in Taiwan

Contemporary management of infective native aortic aneurysms

A rare case of mycotic aortic aneurysm with Clostridium perfringens culture

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