Classification and management of mycotic aneurysms.

After a review of 14 patients with extracranial mycotic aneurysms, a classification of mycotic aneurysms has been proposed based upon the pre-existing pathologic condition of the artery and on the pathogenesis. Ten aneurysms resulted from an infection due to intravascular sources and four, due to extravascular sources. Ten patients in this series were treated surgically, and of these, eight were cured. All four patients who did not undergo a surgical procedure died. Early diagnosis, appropriate antibiotic therapy and prompt surgical intervention are recommended in the management of these aneurysms. Excision or exclusion of aneurysms is preferred. If necessary, the circulation to the distal part of the extremity can be restored by vascular reconstruction using an autogenous bypass graft, preferably through a noninfected field.