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经血管腔内修复术治疗的真菌性主动脉瘤:单中心初步经验

Mycotic aortic aneurysms treated by endovascular repair: initial experience in a single center.

作者信息

Bouzas Miguel, Ponte Charlotte, Van Houte Bernard, Vasquez Cesar

机构信息

a Centre Hospitalier Universitaire de Liege , Liège , Belgium.

b CHR Val de sambre , Sambreville , Belgium.

出版信息

Acta Chir Belg. 2019 Jun;119(3):189-194. doi: 10.1080/00015458.2018.1432741. Epub 2018 Jan 30.

Abstract

INTRODUCTION

Mycotic aortic aneurysm (MAA) is an uncommon cause of aneurysmal aortic disease. However, it may have an aggressive presentation and a complicated early outcome. Endovascular aneurysm repair (EVAR) of MAA is emerging as an alternative to open repair (OR) for the treatment of these aneurysms, particularly in high-risk surgical patients. We report a single-center experience with the endovascular management of mycotic aortic aneurysms.

MATERIAL AND METHODS

Two mycotic abdominal aortic aneurysms were treated with an endovascular stent graft at Centre Hospitalier Régional du Val de Sambre, Belgium. The mean follow-up was 15 months. Technical success was achieved in all two patients. CT-scan follow up showed shrinkage of the aneurysm sac, with no evidence of infection along the stent graft and no signs of endoleakage in all patients. One patient died during the follow-up period from a cause unrelated to the aneurysm.

CONCLUSION

EVAR is an effective and safe option and might be a suitable alternative to OR in the absence of predictors of poor prognosis for the treatment of non-complicated forms of MAA.

摘要

引言

真菌性主动脉瘤(MAA)是动脉瘤性主动脉疾病的一种罕见病因。然而,它可能具有侵袭性表现和复杂的早期预后。MAA的血管内动脉瘤修复术(EVAR)正逐渐成为开放性修复术(OR)治疗这些动脉瘤的替代方法,尤其是在高风险手术患者中。我们报告了单中心真菌性主动脉瘤血管内治疗的经验。

材料与方法

比利时桑布尔河谷地区中心医院对两例真菌性腹主动脉瘤进行了血管内支架植入治疗。平均随访时间为15个月。两名患者均取得了技术成功。CT扫描随访显示动脉瘤囊缩小,所有患者的支架移植物沿线均无感染迹象,也无内漏迹象。一名患者在随访期间死于与动脉瘤无关的原因。

结论

对于非复杂性MAA的治疗,在没有预后不良预测因素的情况下,EVAR是一种有效且安全的选择,可能是OR的合适替代方法。

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