Endovascular stent-graft repair of mycotic aneurysms of the aorta: a case series with a 22-month follow-up.

BACKGROUND

The purpose of the present study was to present a single-institution series of patients with mycotic aneurysms of the aorta treated with endovascular stent-graft technology, and to report the efficacy and short-term durability of this repair.

METHODS

A retrospective review of seven consecutive patients with mycotic aneurysms of the aorta treated with stent-graft between May 2006 and July 2007. Patients were diagnosed based on typical appearance of imaging together with a positive bacteriology culture or clinical evidence of infection. A bifurcated, aorto-uni-iliac (AUI) stent-graft and cuff were used in the endovascular repair after infection control. The follow-up protocol included regular clinical examination, hematologic tests, and computed tomography scans at 3, 6, 12, and 24 months.

RESULTS

Endovascular aneurysm repair (EVAR) was performed successfully in the seven patients (all men, median age 56 years), with complete exclusion of the aneurysms. Five of the patients had infrarenal aortic aneurysms, and the other two had descending thoracic aortic aneurysms. The median hospital stay was 22 days, with no hospital deaths. No paraplegia or other major complications occurred. The patients remained well, with no evidence of graft infection at a mean follow-up of 22.7 months (range: 17-26 months). A significant reduction in the diameter of the aneurysm sac was noted on computed tomography scans in all the patients at 1 year (mean: 6.5 mm; range: 3-40 mm).

CONCLUSIONS

Endovascular stent-graft treatment represents an alternative treatment with acceptable short-term outcomes for patients with mycotic aneurysms of the aorta.