Methods: We conducted a retrospective analysis on 39 patients with mycotic aneurysm between 2008-2015 at Kobe University Hospital, Kobe, Japan. We compared these treatments on both in-hospital and one-year mortality.
Results: Eight patients (20.5%) received endovascular repair (ER) with antimicrobial therapy, and remaining 31 underwent surgery (ST). ER group patients were those who refused open surgery or were considered inoperable. The median age for ER group and ST group were 75.5 and 75.0 years old respectively. ER group appeared to have better in-hospital mortality than ST group (12.5% vs 30.0%, p=0.65). However, both groups had similar one-year mortality (37.5% vs 40%, p=1.0). In ER group, the patients received for 4-6 weeks of intravenous antimicrobials followed by oral antimicrobials scheduled to be given for life. Two patients required second treatment for worsening aneurysm, one requiring second endovascular treatment and the other needed open surgery. In ST group, they also received 4-6 weeks of intravenous antimicrobials, but only one half of them were scheduled to receive life long oral therapy.
Conclusion: In our cohort, the outcome of endovascular treatment appeared comparable to conventional surgical treatment, provided that they remained on oral antimicrobials for life. This may be an effective and less invasive option for the treatment of mycotic aneurysm, particularly for those who may not tolerate surgery.
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