title: The changing management of primary mycotic aortic aneurysms.
abstract: OBJECTIVE
  The objective of this study is to examine contemporary management of primary mycotic aortic aneurysms in a single center. We have previously reported the management of mycotic aortic aneurysms in 15 patients between 1991 and 2001, and we hypothesized that management would change in the light of the evolution of endovascular aortic repair.
  
  
  METHODS
  A review of a prospectively collected database (2002-2009) of all patients presenting with mycotic aneurysms.
  
  
  RESULTS
  A total of 19 aneurysms were identified in 17 patients (12 men, 5 women) with a median age of 66.2 years (range, 49-82 years). All were symptomatic, and nine had contained rupture. There were five infrarenal, two juxtarenal, three Crawford type III, four type IV thoracoabdominal aortic aneurysms, and five descending thoracic aneurysms in the series. All thoracic aneurysms were excluded by thoracic endovascular aneurysm repair. Two patients underwent visceral hybrid endografting for type III thoracic aortic aneurysm; the third was treated with open repair. Four patients underwent open type IV repair. Two of the infrarenal aneurysms were treated with bifurcated endovascular aneurysm repair, and the other three and both juxtarenals with open repair with in situ reconstruction. There were three early (17.6%) and three late deaths (17.6%). The median follow-up was 30.5 months (range, 1-102 months).
  
  
  CONCLUSIONS
  The results of the latest series show that open surgery is still required in many cases. The introduction of endovascular techniques in the exclusion of mycotic aneurysms can be accomplished with acceptable results, and endovascular treatment has increased the therapeutic options for a difficult condition.
authors: St Mary's Hospital, Imperial College National Health Service Trust, London, UK.
authors: Nadia
authors: N
authors: Vallejo
authors: Natasha Emma
authors: NE
authors: Picardo
authors: Patricia
authors: P
authors: Bourke
authors: Colin
authors: C
authors: Bicknell
authors: Nicholas J W
authors: NJ
authors: Cheshire
authors: Michael P
authors: MP
authors: Jenkins
authors: John
authors: J
authors: Wolfe
authors: Richard G J
authors: RG
authors: Gibbs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D019992:Databases as Topic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome