ORIGINAL ARTICLE   

Chirurgia 2020 February;33(1):15-7

DOI: 10.23736/S0394-9508.18.04944-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Management of mycotic visceral artery aneurysms in the endovascular era: short- and midterm outcome

Baker M. GHONIEM ✉, Ahmed A. SHAKER, Mahmoud NASSER, Amr GAD

Department of Vascular and Endovascular Surgery, Kasr al Ainy Hospitals, Cairo University, Cairo, Egypt

BACKGROUND: The aim of this article is to analyze ten cases of mycotic visceral artery aneurysm encountered in our institute with special emphasis on short and midterm results.
METHODS: This retrospective study review was performed for all patients treated for mycotic visceral aneurysms along 18 months from January 2015 to July 2016 at Cairo University Kasr al Ainy Hospitals.
RESULTS: Ten patients with mycotic visceral aneurysm were treated. Five cases were male with age ranges between 20 to 48 years. Arteries that were involved four splenic, two superior mesenteric after origin of middle colic, one Jejunal branch and three in hepatic artery. Regarding management, two splenic arteries aneurysms (SAA) were excised with splenectomy and one was coiled, one superior mesenteric artery aneurysm (SMAA) aneurysm was excised with ligation and the other was repaired by saphenous vein due to mesenteric ischemia, Jejunal artery aneurysm was excised with no intestinal resection, one hepatic artery aneurysm (HAA) was aneurysmorraphy and the other was repaired by saphenous vein. During mean 2 years follow-up, there was no morbidity, two cases one was from ruptured splenic artery that was ligated but the patient died three days postoperative in rupture Splenic and one died 6 months later from cardiac cause.
CONCLUSIONS: In the current era of endovascular, open surgery is still is still safe and effective with a good early and midterm results regarding the management of MVA particularly mycotic aneurysms are common in young age population, however more comparative studies should be done to optimize the treatment of VAA.

KEY WORDS: Aneurysm; Infected aneurysm; Splenic artery; Mesentery; Endovascular procedures