Document Detail


Selective medical treatment of infected aneurysms of the aorta in high risk patients.
MedLine Citation:
PMID:  18848757     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Infected aneurysm of the aorta is almost always fatal without undergoing aortic resection. Medical treatment was attempted selectively in patients who were considered too high risk for surgery. We review our experience with 22 patients treated without undergoing aortic resection over 12 years. METHODS: Retrospective chart review. RESULTS: Between 1995 and 2007, 22 cases of infected aortic aneurysms treated without undergoing aortic resection during the first admission were included. There were 17 men with a median age of 76 years (range, 35 to 88 years). Of 18 pathogens isolated, the most common responsible microorganism was nontyphoid Salmonella in 11 followed by Staphylococcus aureus in five. The site of infection was thoracic in eight and abdominal in 14. The hospital mortality rate was 50%, and the aneurysm-related mortality rate after long-term follow-up was 59%. The event-free survival rate at one year was 32%. Of 11 patients with Salmonella infection, eight patients have lived beyond 30 days and six were event-free after one year. Of 11 patients with non-Salmonella, four patients have lived beyond 30 days and only one was event-free after one year. The overall aneurysm-related mortality rate was 36% in Salmonella infected patients and 82% in non-Salmonella infected patients. CONCLUSION: Clinical results of medical treatment using current antibiotics in patients with infected aortic aneurysm were poor. Traditional surgical excision of infected aortic aneurysms with revascularization remains the gold standard and should be attempted except in high risk patients.
Authors:
Ron-Bin Hsu; Chung-I Chang; I-Hui Wu; Fang-Yue Lin
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Publication Detail:
Type:  Journal Article     Date:  2008-10-11
Journal Detail:
Title:  Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter     Volume:  49     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-28     Completed Date:  2009-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  66-70     Citation Subset:  IM    
Affiliation:
Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taiwan, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aneurysm, Infected / drug therapy*,  microbiology,  mortality,  surgery
Anti-Bacterial Agents / therapeutic use*
Aortic Aneurysm / drug therapy*,  microbiology,  mortality,  surgery
Disease-Free Survival
Female
Hospital Mortality
Humans
Male
Middle Aged
Patient Selection*
Retrospective Studies
Risk Assessment
Time Factors
Treatment Outcome
Vascular Surgical Procedures / adverse effects*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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