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Surgical pathology of infected aortic aneurysm and its clinical correlation

Ron-Bin Hsu1, Fang-Yue Lin

  • 1Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.

Annals of Vascular Surgery
|May 15, 2007
PubMed

Insights

Infected aortic aneurysms often involve atherosclerosis and Salmonella. Pathology findings like inflammation and pus may indicate higher risks for graft infection and death.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Pathology

Background:

  • Infected aortic aneurysms (IAAs) are rare but serious conditions.
  • Clinical and pathological correlations of IAAs are infrequently documented.

Purpose of the Study:

  • To investigate the pathology of infected aortic aneurysms.
  • To correlate pathological findings with clinical outcomes, including graft infection and mortality.

Main Methods:

  • Retrospective analysis of 48 patients with IAA undergoing in situ graft replacement (1995-2005).
  • Review of pathological findings (atherosclerosis, inflammation, bacterial presence) and intraoperative observations (pus).
  • Correlation of pathological and clinical data with prosthetic graft infection and aneurysm-related death.

Main Results:

  • Aortic atherosclerosis was universal; nontyphoid Salmonella was the most common pathogen (67%).
  • Acute suppurative inflammation was observed in 65% of cases; gross pus in 54%.
  • Prosthetic graft infection occurred in 21% and aneurysm-related death in 25% of patients.

Conclusions:

  • Infected aortic aneurysms are associated with underlying atherosclerosis.
  • Pathological signs of local purulent infection may predict higher risks of graft complications and mortality.
  • While acute inflammation is common, bacterial clumps are infrequently identified on pathology.

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