The management of mycotic aortic aneurysms: is there a role for endoluminal treatment?
BACKGROUND
Mycotic aneurysms are rare. Conventional surgical options include ligation or excision with in-situ or extra-anatomical reconstruction. The use of endoluminal stenting for mycotic aneurysms in the presence of sepsis is controversial, but may be a temporising measure, or sometimes the only option in the management of critically ill patients who are not fit for surgery.


METHODS
A literature review was undertaken using Medline, all relevant papers on endoluminal management of mycotic aneurysm were taken into account.


RESULTS
Open surgical repair of mycotic aortic aneurysm is associated with considerable peri- and post-operative morbidity and mortality. Endoluminal treatment with stent-grafts has been introduced as an alternative, and early results are promising.


CONCLUSIONS
No level I evidence for the endoluminal treatment of mycotic aneurysms exists. Ideally a randomised controlled trial of open surgery versus endoluminal treatment should be performed but this may be difficult to perform because of the low incidence of infected aneurysms.
Chan
Y C
YC
Department of Vascular and Endovascular Surgery, 1st Floor North Wing, Guy's and St. Thomas' NHS Foundation Hospital, Lambeth Palace Road, London SE1 7EH, UK.
Morales
J P
JP
Taylor
P R
PR
D000785:Aneurysm, Infected / Q000175:diagnosis / Q000601:surgery*; D017130:Angioplasty; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000601:surgery*; D020099:Coated Materials, Biocompatible; D006801:Humans; D015607:Stents
D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible