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Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience

OBJECTIVE: This study was performed to assess the efficacy and outcome of endovascular aneurysm repair (EVAR) for treatment of primary mycotic aortic aneurysms (PMAAs). METHODS: Fourteen consecutive patients who presented with PMAA from April 2010 to July 2017 were retrospectively reviewed. Preopera...

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Autores principales: Luo, Yudong, Zhu, Jiechang, Dai, Xiangchen, Fan, Hailun, Feng, Zhou, Zhang, Yiwei, Hu, Fanguo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136017/
https://www.ncbi.nlm.nih.gov/pubmed/29962258
http://dx.doi.org/10.1177/0300060518781651
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author Luo, Yudong
Zhu, Jiechang
Dai, Xiangchen
Fan, Hailun
Feng, Zhou
Zhang, Yiwei
Hu, Fanguo
author_facet Luo, Yudong
Zhu, Jiechang
Dai, Xiangchen
Fan, Hailun
Feng, Zhou
Zhang, Yiwei
Hu, Fanguo
author_sort Luo, Yudong
collection PubMed
description OBJECTIVE: This study was performed to assess the efficacy and outcome of endovascular aneurysm repair (EVAR) for treatment of primary mycotic aortic aneurysms (PMAAs). METHODS: Fourteen consecutive patients who presented with PMAA from April 2010 to July 2017 were retrospectively reviewed. Preoperative, intraoperative, and postoperative clinical data were recorded, and late infection-related complications and long-term survival were assessed. RESULTS: The aneurysms were located in the abdominal aorta in 10 patients and in the left common iliac artery in 4 patients. Positive microbial cultures were found in 12 patients, including Salmonella species in 11 and Streptococcus in 1. The remaining two patients had negative culture results. Ten patients received preoperative antibiotics before elective EVAR for 7 ± 9 days after admission. Four patients who underwent emergent EVAR due to ruptured aneurysms were given their first dose of antibiotics before EVAR. Three patients underwent surgical drainage, and six underwent percutaneous drainage within 30 days after EVAR. No death occurred within 30 days of the initial procedure. The mean follow-up was 34.8 (range, 3–84 months). One patient underwent re-intervention to resolve obstruction of the iliac/femoral artery 5 months postoperatively. Relapse of infection occurred in six patients (42.8%) during follow-up; infection-related death occurred in three of these patients. The other patients recovered with either conversion to open radical surgery or medical therapy. The actuarial 7-year survival after EVAR was 75.7%. CONCLUSIONS: EVAR and aggressive antibiotic therapy might be suitable for PMAAs. Favorable results may be typical for infection caused by Salmonella.
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spelling pubmed-61360172018-09-17 Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience Luo, Yudong Zhu, Jiechang Dai, Xiangchen Fan, Hailun Feng, Zhou Zhang, Yiwei Hu, Fanguo J Int Med Res Clinical Research Reports OBJECTIVE: This study was performed to assess the efficacy and outcome of endovascular aneurysm repair (EVAR) for treatment of primary mycotic aortic aneurysms (PMAAs). METHODS: Fourteen consecutive patients who presented with PMAA from April 2010 to July 2017 were retrospectively reviewed. Preoperative, intraoperative, and postoperative clinical data were recorded, and late infection-related complications and long-term survival were assessed. RESULTS: The aneurysms were located in the abdominal aorta in 10 patients and in the left common iliac artery in 4 patients. Positive microbial cultures were found in 12 patients, including Salmonella species in 11 and Streptococcus in 1. The remaining two patients had negative culture results. Ten patients received preoperative antibiotics before elective EVAR for 7 ± 9 days after admission. Four patients who underwent emergent EVAR due to ruptured aneurysms were given their first dose of antibiotics before EVAR. Three patients underwent surgical drainage, and six underwent percutaneous drainage within 30 days after EVAR. No death occurred within 30 days of the initial procedure. The mean follow-up was 34.8 (range, 3–84 months). One patient underwent re-intervention to resolve obstruction of the iliac/femoral artery 5 months postoperatively. Relapse of infection occurred in six patients (42.8%) during follow-up; infection-related death occurred in three of these patients. The other patients recovered with either conversion to open radical surgery or medical therapy. The actuarial 7-year survival after EVAR was 75.7%. CONCLUSIONS: EVAR and aggressive antibiotic therapy might be suitable for PMAAs. Favorable results may be typical for infection caused by Salmonella. SAGE Publications 2018-07-01 2018-09 /pmc/articles/PMC6136017/ /pubmed/29962258 http://dx.doi.org/10.1177/0300060518781651 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Clinical Research Reports
Luo, Yudong
Zhu, Jiechang
Dai, Xiangchen
Fan, Hailun
Feng, Zhou
Zhang, Yiwei
Hu, Fanguo
Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience
title Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience
title_full Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience
title_fullStr Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience
title_full_unstemmed Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience
title_short Endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience
title_sort endovascular treatment of primary mycotic aortic aneurysms: a 7-year single-center experience
topic Clinical Research Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136017/
https://www.ncbi.nlm.nih.gov/pubmed/29962258
http://dx.doi.org/10.1177/0300060518781651
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