Endovascular repair of mycotic aneurysm of the descending thoracic aorta.
BACKGROUND
Mycotic thoracic aortic aneurysms (MTAAs) are a rare yet life-threatening disease. The current standard of care consists of surgical resection, in situ or extra-anatomic revascularization, and antibiotic therapy. Despite this treatment, mortality remains high (range, 5-40%). The endovascular repair of degenerative thoracic aortic aneurysms has been shown to be safe and effective, but its use in the treatment of MTAAs is still controversial. The purpose of this study is to review the use of endovascular repair for MTAAs.


METHODS
A 10-year retrospective chart review was conducted of patients who underwent endovascular repair of MTAAs between March 2001 and March 2011. The surgical results of this single-institution review are reported.


RESULTS
Seven patients underwent endovascular repair of MTAAs. One patient died 2 days postoperatively, which gave an in-hospital survival rate of 85.7%. The 1-year survival rate was 71.4%. The mean follow-up time was 25 months (range, 0-72 months), with a survival rate at that time of 57.1%. All patients were free of infection during their follow-up period.


CONCLUSIONS
In this single-center case series, endovascular repair of MTAAs was associated with favorable perioperative and short-term mortality and morbidity.
Division of Vascular Surgery, Rhode Island Hospital, Alpert Medical School Brown University, Providence, RI, USA. johnstone.jill@mayo.edu
Jill K
JK
Johnstone
Jeffery M
JM
Slaiby
Edward J
EJ
Marcaccio
Tze Tec
TT
Chong
Manuel
M
Garcia-Toca
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012237:Rhode Island; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome