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The management of mycotic aortic aneurysms: is there a role for endoluminal treatment?

Y C Chan1, J P Morales, P R Taylor

  • 1Department of Vascular and Endovascular Surgery, 1st Floor North Wing, Guy's and St. Thomas' NHS Foundation Hospital, Lambeth Palace Road, London SE1 7EH, UK.

Acta Chirurgica Belgica
|January 28, 2006
PubMed
Abstract

Insights

Mycotic aneurysms are rare infections of blood vessels. Endoluminal stent-grafts offer promising results as an alternative to open surgery, especially for critically ill patients.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Interventional Radiology

Background:

  • Mycotic aneurysms, rare infections of the aorta, present significant surgical challenges.
  • Conventional treatments include ligation or excision with reconstruction, carrying high risks.
  • Endoluminal stenting is explored for critically ill patients unfit for surgery.

Purpose of the Study:

  • To review the literature on the endoluminal management of mycotic aneurysms.
  • To assess the role and outcomes of endovascular techniques in treating infected aortic aneurysms.

Main Methods:

  • A comprehensive literature review was conducted using the Medline database.
  • All relevant studies on the endoluminal treatment of mycotic aneurysms were included.

Main Results:

  • Open surgical repair of mycotic aortic aneurysms is linked to substantial peri- and post-operative morbidity and mortality.
  • Endoluminal stent-graft treatment is emerging as a viable alternative with promising early outcomes.
  • This approach may be particularly beneficial for patients with sepsis or those unsuitable for open repair.

Conclusions:

  • Currently, no Level I evidence supports endoluminal treatment for mycotic aneurysms.
  • A randomized controlled trial comparing open surgery and endoluminal treatment is ideal but challenging due to low incidence.
  • Endoluminal stenting may serve as a temporizing measure or sole option for high-risk patients.

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