Papadimitriou D, Tachtsi M, Koutsias S, Pitoulias G, Mpompoti T
Vascular Unit of the 2, Surgical Clinic, Aristotelion University of Thessaloniki, G. Gennimatas Hospital, Thessaloniki, Greece.
Vasa. 2003 Nov;32(4):218-20. doi: 10.1024/0301-1526.32.4.218.
The mycotic aneurysms of the infrarenal aorta (MAIA) are extremely rare and the associated morbidity and mortality is very high. The classification of infected aneurysms considers four types: a) true mycotic aneurysms, b) secondary mycotic aneurysms due to bacterial arteritis, c) infected preexisting abdominal aortic aneurysms and d) post-traumatic infected false aneurysms. The prognosis of true MAIA's is better than the other forms of infected aneurysms. The standard treatment includes the resection of the aneurysm and infectious surrounding tissues and the restoration of the flow using ex situ (axillobifemoral) bypass or in situ replacement with autologous vein or a rifampicinebonded graft. We present a case of mycotic aneurysm of the infrarenal aorta and a brief discussion of the alternative treatments from the relevant literature.
肾下腹主动脉霉菌性动脉瘤(MAIA)极为罕见,其相关的发病率和死亡率非常高。感染性动脉瘤的分类有四种:a)真性霉菌性动脉瘤,b)细菌性动脉炎所致的继发性霉菌性动脉瘤,c)感染的腹主动脉瘤,d)创伤后感染性假性动脉瘤。真性MAIA的预后优于其他形式的感染性动脉瘤。标准治疗包括切除动脉瘤及感染的周围组织,并通过异位(腋双股)旁路或用自体静脉或利福平结合移植物原位置换来恢复血流。我们报告一例肾下腹主动脉霉菌性动脉瘤病例,并对相关文献中的替代治疗方法进行简要讨论。