未经证实:布鲁氏菌动脉瘤非常罕见,但危及生命,标准的治疗方法尚未建立。本研究旨在评估布鲁氏菌动脉瘤血管内治疗的安全性和有效性。
UNASSIGNED:回顾性收集并分析2012年1月至2021年12月在2家医院行血管内修复术的15例布氏杆菌主髂动脉瘤患者的临床资料。
UNASSIGNED:包括15例患者(12例男性和3例女性),平均年龄为59.3岁。14名患者(93.3%)有动物(牛和羊)接触史。所有患者都有主动脉或髂动脉假性动脉瘤,9腹主动脉瘤(AAAs),4个髂动脉瘤,2例AAA合并髂动脉瘤。所有患者均进行了血管内动脉瘤修复(EVAR),而没有转换为开放手术。6例因动脉瘤破裂行急诊手术治疗。即时技术成功率为100%,没有术后死亡。2例因缺乏抗生素治疗,术后髂动脉再次破裂,再次行血管内治疗。一旦诊断出布鲁氏菌病,所有患者均开始接受多西环素和利福平的抗生素治疗,直至术后6个月.所有患者均存活了45个月的中位随访期。后续计算机断层扫描血管造影显示,所有支架移植物均保持通畅,没有内漏。
UNASSIGNED:EVAR联合抗生素治疗是可行的,安全,并对布鲁氏菌动脉瘤有效,代表了这些布鲁氏菌动脉瘤的有希望的治疗选择。
结论:布鲁氏菌动脉瘤非常罕见,但危及生命,标准的治疗方法尚未建立。传统的手术管理策略是手术切除和清创感染的动脉瘤及其周围组织。然而,这些患者的开放式手术治疗会导致严重的创伤,手术风险和死亡率很高(13.3%-40%)。我们尝试通过血管内治疗来治疗布鲁氏杆菌动脉瘤,手术的技术成功率和成活率达到100%。EVAR联合抗生素治疗是可行的,安全,对布鲁氏菌动脉瘤有效,代表了一些霉菌性动脉瘤的有希望的治疗选择。
UNASSIGNED: Brucella aneurysms are very rare but life-threatening, and a standard treatment approach has yet to be established. The current study aimed to assess the safety and efficacy of endovascular treatment for Brucella aneurysms.
UNASSIGNED: The clinical data of 15 Brucella aortic-iliac aneurysm patients who underwent endovascular repair at 2 hospitals from January 2012 to December 2021 were retrospectively collected and analyzed.
UNASSIGNED: Fifteen patients (12 men and 3 women) with a mean age of 59.3 years were included. Fourteen patients (93.3%) had a history of exposure to animals (cattle and sheep). All patients had aortic or iliac pseudoaneurysms, 9 abdominal aortic aneurysms (AAAs), 4 iliac aneurysms, and 2 AAA combined with iliac aneurysms. Endovascular aneurysm repair (EVAR) was performed in all patients without conversion to open surgery. Six cases were treated for emergency surgery due to aneurysm rupture. The immediate technique success rate was 100%, with no postoperative death. Two cases had the iliac artery ruptured again after operation because of lack of antibiotic treatment and was given endovascular treatment again. Once brucellosis is diagnosed, antibiotic treatment with doxycycline and rifampicin was initiated for all the patients until 6 months after operation. All patients survived over a median follow-up period of 45 months. Follow-up computed tomography angiography showed that all stent grafts remained patent, with no endoleak.
UNASSIGNED: EVAR combined with antibiotics treatment is feasible, safe, and effective for Brucella aneurysms and represents a promising treatment option for these Brucella aneurysms.
CONCLUSIONS: Brucella aneurysms are very rare but life-threatening, and a standard treatment approach has yet to be established. The traditional operation management strategy is surgical resection and debridement of the infected aneurysm and the surrounding tissues. However, open surgical management in these patients causes severe trauma with high surgical risks and mortality (13.3%-40%). We tried to treat Brucella aneurysms with endovascular therapy, and the technique success and survival rate of the operation reached 100%. EVAR combined with antibiotics treatment is feasible, safe, and effective for Brucella aneurysms and represents a promising treatment option for some mycotic aneurysms.