Department of Vascular Surgery, King's College Hospital, London, United Kingdom.
Department of Vascular Surgery, King's College Hospital, London, United Kingdom.
Ann Vasc Surg. 2021 Aug;75:531.e7-531.e13. doi: 10.1016/j.avsg.2021.01.105. Epub 2021 Apr 6.
The management of abdominal aortic aneurysms (AAA) has evolved significantly with the advent of endovascular strategies. Thus, there has been a decline in the number of open AAA repairs once an endovascular option is available. There have also been reports of successful endovascular management of infective native aortic aneurysms (INAA), previously called mycotic aneurysms. The rarity of this condition makes its management a challenging one as there are no standard guidelines. The European Society of Vascular Surgery has suggested that the nomenclature be changed from mycotic aneurysms as this can be misleading to standardise reporting. The authors' present a case of a 67-year old male who presented during the peak of the Corona Virus pandemic with constitutional gastrointestinal symptoms. He was subsequently diagnosed with an INAA and successfully managed with open Neo-Aorto Iliac System reconstruction with a homograft. The report highlights various strategies used in the surgical approach and their benefits in the management of INAA. Furthermore, a literature review of Streptococcus (Streptococcus agalactiae) species as a rare cause of INAA and how these cases were managed are also highlighted.
腹主动脉瘤(AAA)的管理随着腔内治疗策略的出现而发生了重大变化。因此,一旦有腔内治疗的选择,开放的 AAA 修复数量就会减少。也有报道称,感染性原生主动脉瘤(INAA),以前称为真菌性动脉瘤,可以通过腔内治疗成功管理。这种情况的罕见性使其管理成为一个具有挑战性的问题,因为没有标准的指南。欧洲血管外科学会建议将命名法从真菌性动脉瘤改为感染性原生主动脉瘤,因为这可能会对标准报告产生误导。作者报告了一例 67 岁男性患者,他在冠状病毒大流行高峰期出现胃肠道症状。他随后被诊断为 INAA,并成功接受了开放的 Neo-Aorto Iliac System 重建和同种异体移植。该报告强调了在手术方法中使用的各种策略及其在 INAA 管理中的益处。此外,还强调了链球菌(无乳链球菌)作为 INAA 的罕见病因以及如何管理这些病例。