腔内移植物治疗真菌性主动脉瘤。
Treatment of mycotic aortic aneurysms with endoluminal grafts.
作者信息
Jones K G, Bell R E, Sabharwal T, Aukett M, Reidy J F, Taylor P R
机构信息
Department of Vascular Surgery, Guy's and St Thomas' Hospital, London SE1 7EH, UK.
出版信息
Eur J Vasc Endovasc Surg. 2005 Feb;29(2):139-44. doi: 10.1016/j.ejvs.2004.11.008.
PURPOSE
To report the benefit of endoluminal repair of mycotic aortic aneurysms and highlight the need for a registry.
METHODS
Nine patients (five female) were identified over 5 years (1998-2003) as having presumed mycotic aortic aneurysms (12 in total) suitable for endoluminal grafting. A total of nine thoracic and three abdominal were grafted and followed up for a median of 36 months.
RESULTS
Six of the aneurysms have resolved and one was converted to an open repair. There was one early death from rupture of a second undiagnosed aneurysm and two late deaths from rupture due to persistent inflammation. Long-term antibiotics have not been mandatory to ensure survival.
CONCLUSIONS
Mycotic aortic aneurysms of the thoracic and abdominal aorta do benefit from endoluminal repair, particularly when arising in previously normal aortic tissue. Endoluminal grafting also has a role in the palliation of secondarily infected aortas and so to prove its efficacy in the treatment of all these rare cases a registry is required.
目的
报告腔内修复感染性主动脉瘤的益处，并强调建立登记系统的必要性。
方法
在5年（1998 - 2003年）期间，共确定9例（5例女性）疑似感染性主动脉瘤患者（共12个动脉瘤）适合腔内移植。总共对9个胸段和3个腹段进行了移植，并进行了中位时间为36个月的随访。
结果
6个动脉瘤已消退，1个转为开放修复。有1例早期死亡，原因是另一个未被诊断出的动脉瘤破裂；2例晚期死亡，原因是持续性炎症导致的破裂。长期使用抗生素并非确保生存的必要条件。
结论
胸主动脉和腹主动脉的感染性动脉瘤确实从腔内修复中获益，尤其是当动脉瘤出现在先前正常的主动脉组织中时。腔内移植在缓解继发感染的主动脉方面也有作用，因此，为证明其在治疗所有这些罕见病例中的疗效，需要建立一个登记系统。
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