Surgical Treatment of Infected Aortoiliac Aneurysmopen access
- Authors
- 윤중기; 김서민; 한아람; 최찬중; 민상일; 하종원; 김상중; 민승기
- Issue Date
- Jun-2015
- Publisher
- 대한혈관외과학회
- Keywords
- Infected aneurysm; Operation; Endovascular procedure; Bypass; Mycobacterium
- Citation
- Vascular Specialist International, v.31, no.2, pp 41 - 46
- Pages
- 6
- Journal Title
- Vascular Specialist International
- Volume
- 31
- Number
- 2
- Start Page
- 41
- End Page
- 46
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/70571
- DOI
- 10.5758/vsi.2015.31.2.41
- ISSN
- 2288-7970
2288-7989
- 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.
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