1114. Outcome of Endovascular Repair with Suppressive Antimicrobial Therapy for Mycotic Aneurysm Compared with Surgery : A Retrospective Comparative Analysis
Session: Poster Abstract Session: Clinical Infectious Diseases: Bacteremia and Endocarditis
Friday, October 28, 2016
Room: Poster Hall
Background: Mycotic aneurysm is a rare infection. Surgery and long-time antibiotic therapy is considered standard therapy. Previous studies suggested endovascular repair could be an alternative to surgical repair, but its effectiveness has never been validated. We therefore conducted a retrospective comparative study to see the clinical effectiveness of endovascular repair for mycotic aneurysm.

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.

Taiji Koyama, M.D, Infectious Disease, Kobe University Hospital, Kobe,Hyogo pref, Japan and Kentaro Iwata, MD, PhD, FACP, FIDSA, Division of Infectious Diseases Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan

Disclosures:

T. Koyama, None

K. Iwata, None

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