PDF(Pubmed)
Abstract：
UNASSIGNED: Mycotic subclavian artery aneurysms (SAAs) are a very rare disorder.
UNASSIGNED: To provide an overview of current knowledge on clinical features, management strategies and outcome evaluations of mycotic SAAs.
UNASSIGNED: The study materials were based on comprehensive literature retrieval of publications of mycotic SAAs published between 2000 and 2023.
UNASSIGNED: Contaminated mechanical injuries and abscess erosions of the arterial walls are mechanisms of mycotic SAAs. The diagnosis relies on detection of pathogenic microorganisms by cultures or microbiological investigations of blood, other fluids and infected tissues as well as medical imaging visualization. The indications for an interventional therapy were poor general condition, high surgical risk, and rescue exclusion for a ruptured pseudoaneurysm. Three (9.1%) pre-treatment deaths were a result of sudden rupture of the mycotic SAAs and thus they lost the opportunity of treatment. All post-treatment deaths occurred in the interventional patient group, whereas the causes of death seemed to be unrelated to mycotic SAAs per se or to treatments of choice. Patient outcome evaluations revealed no significant difference between different treatments of choice. No significant predictive risk factors were responsible for patient outcomes.
UNASSIGNED: Once a diagnosis of mycotic SAA is made, sensitive antibacterial drugs are applied immediately to control the infection and control aneurysmal progression. Early treatment is conducted as soon as possible to avoid aneurysmal rupture. A decision on treatment of choice is made based on the patient\'s specific condition. Antibacterial drug use is continued for about 6 weeks after surgical or interventional therapy.
UNASSIGNED: To provide an overview of current knowledge on clinical features, management strategies and outcome evaluations of mycotic SAAs.
UNASSIGNED: The study materials were based on comprehensive literature retrieval of publications of mycotic SAAs published between 2000 and 2023.
UNASSIGNED: Contaminated mechanical injuries and abscess erosions of the arterial walls are mechanisms of mycotic SAAs. The diagnosis relies on detection of pathogenic microorganisms by cultures or microbiological investigations of blood, other fluids and infected tissues as well as medical imaging visualization. The indications for an interventional therapy were poor general condition, high surgical risk, and rescue exclusion for a ruptured pseudoaneurysm. Three (9.1%) pre-treatment deaths were a result of sudden rupture of the mycotic SAAs and thus they lost the opportunity of treatment. All post-treatment deaths occurred in the interventional patient group, whereas the causes of death seemed to be unrelated to mycotic SAAs per se or to treatments of choice. Patient outcome evaluations revealed no significant difference between different treatments of choice. No significant predictive risk factors were responsible for patient outcomes.
UNASSIGNED: Once a diagnosis of mycotic SAA is made, sensitive antibacterial drugs are applied immediately to control the infection and control aneurysmal progression. Early treatment is conducted as soon as possible to avoid aneurysmal rupture. A decision on treatment of choice is made based on the patient\'s specific condition. Antibacterial drug use is continued for about 6 weeks after surgical or interventional therapy.
摘要：
■霉菌性锁骨下动脉动脉瘤（SAAs）是一种非常罕见的疾病。
■为了概述有关临床特征的最新知识，霉菌性SAA的管理策略和结果评估。
■研究材料基于对2000年至2023年之间发表的真菌SAA出版物的全面文献检索。
■受污染的机械损伤和动脉壁的脓肿侵蚀是霉菌性SAA的机制。诊断依赖于通过血液的培养或微生物学研究来检测病原微生物，其他液体和感染组织以及医学成像可视化。介入治疗的适应症是一般情况较差，手术风险高,以及假性动脉瘤破裂的救援排除。三例（9.1％）治疗前死亡是由于霉菌性SAA突然破裂所致，因此他们失去了治疗机会。所有治疗后死亡均发生在介入患者组中，而死亡原因似乎与霉菌性SAA本身或选择的治疗无关。患者预后评估显示，选择的不同治疗方法之间没有显着差异。没有显著的预测风险因素对患者预后负责。
■一旦诊断为霉菌性SAA，立即应用敏感抗菌药物控制感染和动脉瘤进展。尽早进行治疗以避免动脉瘤破裂。根据患者的具体情况决定选择治疗方法。在手术或介入治疗后持续使用抗菌药物约6周。
■为了概述有关临床特征的最新知识，霉菌性SAA的管理策略和结果评估。
■研究材料基于对2000年至2023年之间发表的真菌SAA出版物的全面文献检索。
■受污染的机械损伤和动脉壁的脓肿侵蚀是霉菌性SAA的机制。诊断依赖于通过血液的培养或微生物学研究来检测病原微生物，其他液体和感染组织以及医学成像可视化。介入治疗的适应症是一般情况较差，手术风险高,以及假性动脉瘤破裂的救援排除。三例（9.1％）治疗前死亡是由于霉菌性SAA突然破裂所致，因此他们失去了治疗机会。所有治疗后死亡均发生在介入患者组中，而死亡原因似乎与霉菌性SAA本身或选择的治疗无关。患者预后评估显示，选择的不同治疗方法之间没有显着差异。没有显著的预测风险因素对患者预后负责。
■一旦诊断为霉菌性SAA，立即应用敏感抗菌药物控制感染和动脉瘤进展。尽早进行治疗以避免动脉瘤破裂。根据患者的具体情况决定选择治疗方法。在手术或介入治疗后持续使用抗菌药物约6周。
