Razavi Mahmood K, Razavi Milad D
St. Joseph Vascular Institute, 1100 West Stewart Drive, Orange, CA 92868, USA.
J Vasc Interv Radiol. 2008 Jun;19(6 Suppl):S51-6. doi: 10.1016/j.jvir.2008.02.012.
Mycotic aneurysms are rare but are associated with a high risk of rupture if not treated promptly. The early mortality rate associated with traditional surgery depends on patients' condition and can be as high as 43%. The use of stent-grafts is less invasive but the outcome is unproven in the setting of infected aneurysms. In an attempt to better elucidate the role of stent-grafts in this setting, a literature search was performed to examine 52 articles describing 91 patients with mycotic aneurysms who were treated with stent-grafts. The early mortality rate was 5.6%. Incidences of late aneurysm-related mortality and complications were 12.2% and 7.8%, respectively. The most consistent predictor of poor outcome was development of aortoenteric fistula. Although the 30-day mortality rate associated with the use of stent-grafts appears to be lower than that associated with surgery, late aneurysm-related events are frequent and warrant a more vigilant follow-up regimen than used with noninfected aneurysms.
真菌性动脉瘤较为罕见，但如果不及时治疗，破裂风险很高。传统手术相关的早期死亡率取决于患者的病情，可达43%之高。使用覆膜支架侵入性较小，但在感染性动脉瘤的情况下其效果尚无定论。为了更好地阐明覆膜支架在这种情况下的作用，我们进行了文献检索，以研究52篇描述91例接受覆膜支架治疗的真菌性动脉瘤患者的文章。早期死亡率为5.6%。晚期动脉瘤相关死亡率和并发症发生率分别为12.2%和7.8%。预后不良最一致的预测因素是主动脉肠瘘的发生。虽然使用覆膜支架相关的30天死亡率似乎低于手术相关的死亡率，但晚期动脉瘤相关事件很常见，需要比非感染性动脉瘤更密切的随访方案。
