Surgical treatment of infected aortic aneurysm

Moneta, Gregory L.; Taylor, Lloyd M.; Yeager, Richard A.; Edwards, James M.; Nicoloff, Alexander D.; McConnell, Donald B.; Porter, John M.

doi:10.1016/s0002-9610(98)00056-7

Cited by 177 publications

(139 citation statements)

References 15 publications

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“…Before the popularized use of antibiotics, nonhemolytic Streptococcus species have once been the most common infectious organisms; subsequently, they account for less than 10% of infection cases after the advent of the antibiotic era [5,36]. Currently, in Western countries, Staphylococcus species are generally the most common pathogens, accounting for 28-71% of cases based on published literatures [13,37,38]. It is also noteworthy that methicillin-resistant Staphylococcus aureus (MRSA) prevalence is continuously rising, and some reports indicated MRSA as the most dominant pathogen [39,40].…”

Section: Bacteriologymentioning

confidence: 99%

“…Vancomycin-intermediate Staphylococcus aureus (VISA) has also been associated with infected aneurysms [41]. Gram-negative bacterium-related infected aortic aneurysms are less prevalent in Western countries than in East Asia, where Salmonella species are the most frequent Gram-negative bacteria causing aortic infections [11,13,38]. A diseased aorta, such as that with significant atherosclerotic change or preexisting aneurysm, is more vulnerable to Salmonella species [11].…”

Section: Bacteriologymentioning

confidence: 99%

“…The therapeutic considerations for infected aortic aneurysms include perioperative medical management (i.e., preoperative and postoperative antibiotic selection and course), timing and type of surgical procedures (traditional excision, debridement, and reconstruction versus endovascular technique), and the necessity of adjunctive procedures [7][8][9][10][11][12][13][14][15]. Complications occasionally occur at the initial presentation, including massive exsanguination due to free rupture and the development of aneurysm-related fistulations.…”

Section: Introductionmentioning

confidence: 99%

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Infected Aortic Aneurysms

Lin¹,

Kan²

2017

Aortic Aneurysm

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Infected aortic aneurysms are surgical urgencies, requiring prompt management to avoid the development of catastrophic complications. Although traditional open surgery composed of radical debridement and aortic reconstruction remains the gold-standard, many favorable results of the endovascular repair strategy have been reported. In this chapter, the etiology, bacteriology, clinical manifestation, and diagnostic criteria of infected aortic aneurysms will be discussed in detail at first, followed by a comprehensive review of both traditional open surgery and endovascular repair, based on current evidences and the authors' institutional experience. Along with long-term oral antibiotic suppression and aggressive adjunctive procedures, endovascular repair for uncomplicated infected aortic aneurysms could be a definite treatment alternative to traditional open surgery in the endovascular era.

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Section: Bacteriologymentioning

confidence: 99%

Section: Bacteriologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Infected Aortic Aneurysms

Lin¹,

Kan²

2017

Aortic Aneurysm

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“…Traditionally, aortic ligation with extra-anatomic bypass, such as axillary-femoral bypass grafting, has been advocated in cases of infrarenal aneurysms to avoid late infective complications [5,16]. Unfortunately, extra-anatomic bypass has been associated with higher rates of peri-operative complications and decreased long-term patency.8 Previous studies, for example, have reported a 20% risk of aortic stump disruption, a 20% to 29% amputation rate, and a 20% risk of reinfection [4,17]. In situ graft reconstruction, on the other hand, has been shown in multiple studies to be a safe and durable option, with no significant difference in graft-related complications or long-term survival [4, 16,18].…”

Section: Case Reportmentioning

confidence: 99%

Ruptured Mycotic Aortic Aneurysm Secondary to Escherichia Coli Bacteremia in an HIV-Positive Patient

Ward¹,

Ruddy²

2017

J Clin Case Rep

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Mycotic aortic aneurysms are an aggressive form of degenerative remodeling reported more commonly in immunosuppressed patients. These aneurysms carry a high risk of progression to rupture, fulminant sepsis, and death, and therefore require prompt operative intervention. The human immunodeficiency virus (HIV) has also been associated with a broad spectrum of vascular disease, including development of aneurysms, however these have typically been identified in the peripheral vasculature. We report the case of a 71-year-old, HIV-positive male who presented with Escherichia coli bacteremia and aortitis which rapidly progressed to a ruptured infrarenal mycotic aortic aneurysm. He was managed successfully with open debridement and in situ implantation of a rifampin-soaked prosthetic graft as well as long-term antibiotic therapy. Here, we review the epidemiology, pathophysiology, and optimal surgical treatment of mycotic aortic aneurysms.

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“…Symptoms are not typical, and vague abdominal or back pain may or may not accompany pyrexia whereas leukocytosis although almost uniformly present represents a non-specific finding [4]. Surgery is considered the mainstay of treatment, and in the presence of visceral involvement, most authors advocate routine in situ aortic revascularization [5,6].…”

mentioning

confidence: 99%

Kidney Salvage During Surgical Treatment of a Pararenal Mycotic Aortic Aneurysm

et al. 2013

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Mycotic abdominal aortic aneurysms although rare are accompanied by an extensive risk of morbidity and mortality. Surgical treatment is challenging, but it offers the only chance of survival. Extra-anatomic aortic reconstruction through uninfected tissues is feasible, providing a durable therapeutic option in the presence of severe infection.Keywords Fever of unknown origin . Renal revascularization . Extra-anatomic bypass . Mycotic aneurysm . Prostheses and implants . Vascular surgical procedures Case SummaryA 64-year-old patient with a fever of unknown origin during the last 20 days underwent a computed tomography scan which displayed a previously known infrarenal small abdominal aortic aneurysm (AAA) as well as a newly diagnosed 4.5 cm pararenal saccular aneurysm located in the right anterior abdominal aortic segment, including the right renal and the left renal artery ostia (Fig. 1). Preoperative blood cultures revealed Staphylococcus hominis which along with clinical and radiological findings, in the absence of an alternative diagnosis, suggested a high probability of a mycotic AAA (MAAA).

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Surgical treatment of infected aortic aneurysm

Cited by 177 publications

References 15 publications

Infected Aortic Aneurysms

Infected Aortic Aneurysms

Ruptured Mycotic Aortic Aneurysm Secondary to Escherichia Coli Bacteremia in an HIV-Positive Patient

Kidney Salvage During Surgical Treatment of a Pararenal Mycotic Aortic Aneurysm

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