Y C Chan1, J P Morales, P R Taylor. 1. Department of Vascular and Endovascular Surgery, 1st Floor North Wing, Guy's and St. Thomas' NHS Foundation Hospital, Lambeth Palace Road, London SE1 7EH, UK.
Abstract
BACKGROUND: Mycotic aneurysms are rare. Conventional surgical options include ligation or excision with in-situ or extra-anatomical reconstruction. The use of endoluminal stenting for mycotic aneurysms in the presence of sepsis is controversial, but may be a temporising measure, or sometimes the only option in the management of critically ill patients who are not fit for surgery. METHODS: A literature review was undertaken using Medline, all relevant papers on endoluminal management of mycotic aneurysm were taken into account. RESULTS: Open surgical repair of mycotic aortic aneurysm is associated with considerable peri- and post-operative morbidity and mortality. Endoluminal treatment with stent-grafts has been introduced as an alternative, and early results are promising. CONCLUSION: No level I evidence for the endoluminal treatment of mycotic aneurysms exists. Ideally a randomised controlled trial of open surgery versus endoluminal treatment should be performed but this may be difficult to perform because of the low incidence of infected aneurysms.
BACKGROUND:Mycotic aneurysms are rare. Conventional surgical options include ligation or excision with in-situ or extra-anatomical reconstruction. The use of endoluminal stenting for mycotic aneurysms in the presence of sepsis is controversial, but may be a temporising measure, or sometimes the only option in the management of critically illpatients who are not fit for surgery. METHODS: A literature review was undertaken using Medline, all relevant papers on endoluminal management of mycotic aneurysm were taken into account. RESULTS: Open surgical repair of mycotic aortic aneurysm is associated with considerable peri- and post-operative morbidity and mortality. Endoluminal treatment with stent-grafts has been introduced as an alternative, and early results are promising. CONCLUSION: No level I evidence for the endoluminal treatment of mycotic aneurysms exists. Ideally a randomised controlled trial of open surgery versus endoluminal treatment should be performed but this may be difficult to perform because of the low incidence of infected aneurysms.