title: Hybrid Treatment: Expanding the Armamentarium for Infected Infrarenal Abdominal Aortic and Iliac Aneurysms.
abstract: OBJECTIVE
  To investigate safety and efficacy of hybrid treatment for infected aortic and iliac aneurysms.
  
  
  METHODS
  Between July 2007 and May 2011, hybrid treatment was performed in 6 male patients (mean age, 67.7 y; range, 57-76 y). Hybrid treatment consisted of extraanatomic bypass (EAB) and isolation of infected aneurysm with vascular plugs. Aneurysms were divided into primary and secondary infected aneurysms. Primary infected aneurysm refers to an aneurysm arising from bacterial infection of the native arterial wall; secondary infected aneurysm refers to infection involving an aneurysm that was previously treated with graft placement.
  
  
  RESULTS
  The infected aneurysm involved the infrarenal abdominal aorta in 4 patients and common iliac artery in 2 patients. Hybrid treatment was successful in all 6 patients. The 3 patients with primary infected aneurysms required only hybrid treatment, whereas infected graft excision and new graft interposition was performed in 2 of the 3 patients with secondary infected aneurysms. No 30-day mortality or complications were reported. During mean follow-up of 58.6 months (range, 32.6-75.8 months), 1 patient (17%) with a secondary infected aneurysm who did not undergo additional surgery died 32.6 months after hybrid treatment from hypovolemic shock secondary to recurrent aortoenteric fistula. Cumulative survival was 100%, 100%, 83%, and 83% at 3 months, 1 year, 3 years, and 5 years.
  
  
  CONCLUSIONS
  Hybrid treatment appears to be a stand-alone, curative treatment for primary infected aneurysms and serves as bridge therapy to subsequent surgery for secondary infected aneurysms.
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Korea.
authors.forename: Kichang
authors.initials: K
authors.lastname: Han
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Korea.
authors.forename: Do Yun
authors.initials: DY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Korea. Electronic address: MDKIM@yuhs.ac.
authors.forename: Man-Deuk
authors.initials: MD
authors.lastname: Kim
authors.affiliation: Department of Cardiothoracic Surgery, Cardiovascular Center, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
authors.forename: Sak
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Korea.
authors.forename: Jong Yun
authors.initials: JY
authors.lastname: Won
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Korea.
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Kwon
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D003131:Combined Modality Therapy; D000072226:Computed Tomography Angiography; D020878:Device Removal; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome