Received 14 October 2008; accepted 2 January 2009. published online 18 May 2009.
Purpose
We report our single-center experience of early and midterm outcome after endovascular repair of mycotic aortic aneurysms (MAA).
Methods
Case records were retrospectively reviewed of 11 patients who underwent endovascular repair of 13 MAAs between 2000 and 2007. The aneurysms were localized in the aortic arch in 1 patient, descending thoracic aorta in 4, suprarenal abdominal aorta in 3, and infrarenal abdominal aorta in 5.
Results
Mean follow-up was 27 months. A bleeding aortoesophageal fistula resulted in one in-hospital death ≤30 days. Three patients died later: one each of sepsis, stent migration that caused intestinal ischemia, and an unknown cause. Two patients had recurrent sepsis postoperatively but no vascular complications, two had elevated inflammatory markers during follow-up but were asymptomatic, and three patients had an uneventful follow-up.
Conclusions
Endovascular treatment for MAA was feasible, with acceptable perioperative mortality and midterm outcome in this single-center case series. Recurrent sepsis and late relapse with a second MAA occurred, indicating the need of long-term antibiotic therapy and follow-up, as well as the possible need for secondary open repair in selected cases. Further research is warranted to evaluate long-term outcome.
aDepartment of Surgery, Section of Vascular Surgery, Uppsala University Hospital, Uppsala, Sweden
bDepartment of Radiology, Section of Interventional Radiology, Uppsala University Hospital, Uppsala, Sweden
Correspondence: Dr Anders Wanhainen, Department of Surgery, Section of Vascular Surgery, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
ABSTRACT