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Surgical Treatment of Infected Aortoiliac Aneurysm.

Youn JK, Kim SM, Han A, Choi C, Min SI, Ha J, Kim SJ, Min SK - Vasc Specialist Int (2015)

Bottom Line: There were 3 in-hospital mortalities and the causes were sepsis in 2 and aneurysm rupture in 1.IAAA develops from various causes and various organisms.In situ reconstruction is favorable for long term-safety and efficacy, but extensive debridement is essential.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Infected aneurysms of the abdominal aorta or iliac artery (IAAA) are rare but fatal and difficult to treat. The purpose of this study was to review the clinical presentations and outcomes of IAAA and to establish a treatment strategy for optimal treatment of IAAA.

Materials and methods: Electronic medical records of 13 patients treated for IAAA at Seoul National University Hospital between March 2004 and December 2012 were retrospectively reviewed.

Results: Mean age was 64.2 (median 70, range 20-79) years. Aneurysms were located in the infrarenal aorta (n=7), iliac arteries (n=5), and suprarenal aorta (n=1). Seven patients underwent excision and in situ interposition graft, 3 underwent extra-anatomical bypass, and 1 underwent endovascular repair. One patient with endovascular repair in an outside hospital refused resection, and only debridement was done, which revealed tuberculosis infection. One staphylococcal infection was caused by iliac stenting. Mycobacterium was the most common pathogen, followed by Klebsiella, Salmonella, and Staphylococcus. There were 3 in-hospital mortalities and the causes were sepsis in 2 and aneurysm rupture in 1. The 3 extra-anatomic bypasses were all patent after 5-year follow-up.

Conclusion: IAAA develops from various causes and various organisms. IAAA cases with gross pus were treated with extra-anatomic bypass, which was durable. In situ reconstruction is favorable for long term-safety and efficacy, but extensive debridement is essential.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier survival curve for each type of operation.
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f2-vsi-31-41: Kaplan-Meier survival curve for each type of operation.

Mentions: Ten patients survived with a mean follow-up of 31.5 (1–63) months. Two patients were lost after a mean follow-up of 3 (1–5) months. Eight patients are currently being followed and have not reported any graft-related complications. Fig. 2 shows the survival according to each type of surgery.


Surgical Treatment of Infected Aortoiliac Aneurysm.

Youn JK, Kim SM, Han A, Choi C, Min SI, Ha J, Kim SJ, Min SK - Vasc Specialist Int (2015)

Kaplan-Meier survival curve for each type of operation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508656&req=5

f2-vsi-31-41: Kaplan-Meier survival curve for each type of operation.
Mentions: Ten patients survived with a mean follow-up of 31.5 (1–63) months. Two patients were lost after a mean follow-up of 3 (1–5) months. Eight patients are currently being followed and have not reported any graft-related complications. Fig. 2 shows the survival according to each type of surgery.

Bottom Line: There were 3 in-hospital mortalities and the causes were sepsis in 2 and aneurysm rupture in 1.IAAA develops from various causes and various organisms.In situ reconstruction is favorable for long term-safety and efficacy, but extensive debridement is essential.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Infected aneurysms of the abdominal aorta or iliac artery (IAAA) are rare but fatal and difficult to treat. The purpose of this study was to review the clinical presentations and outcomes of IAAA and to establish a treatment strategy for optimal treatment of IAAA.

Materials and methods: Electronic medical records of 13 patients treated for IAAA at Seoul National University Hospital between March 2004 and December 2012 were retrospectively reviewed.

Results: Mean age was 64.2 (median 70, range 20-79) years. Aneurysms were located in the infrarenal aorta (n=7), iliac arteries (n=5), and suprarenal aorta (n=1). Seven patients underwent excision and in situ interposition graft, 3 underwent extra-anatomical bypass, and 1 underwent endovascular repair. One patient with endovascular repair in an outside hospital refused resection, and only debridement was done, which revealed tuberculosis infection. One staphylococcal infection was caused by iliac stenting. Mycobacterium was the most common pathogen, followed by Klebsiella, Salmonella, and Staphylococcus. There were 3 in-hospital mortalities and the causes were sepsis in 2 and aneurysm rupture in 1. The 3 extra-anatomic bypasses were all patent after 5-year follow-up.

Conclusion: IAAA develops from various causes and various organisms. IAAA cases with gross pus were treated with extra-anatomic bypass, which was durable. In situ reconstruction is favorable for long term-safety and efficacy, but extensive debridement is essential.

No MeSH data available.


Related in: MedlinePlus