Infected aneurysms of necks and limb arteries: A retrospective multicenterstudy

Infected aneurysms (IA) of neck and limb arteries are uncommon. This report describes the results of a retrospective study undertaken by the Universit y Association for Surgical Research (AURC) to evaluate etiology, bacteriolo gy, location, diagnostic features, and therapeutic methods associated with IA. A total of 58 IA in 52 patients were reviewed. The lesion was located i n a lower extremity artery in 47 patients (81%), internal carotid artery in 7 (12%), and upper extremity artery in 4 (6%). Eleven patients had multilo cular aneurysm (21%). Symptoms of local infection were observed in 43 patie nts (82.6%). Rupture or splitting was the presenting manifestation in 13 pa tients (25%). Primary IA following bacteremia or septicemia without endocar ditis was the most common type of IA observed in 34 patients (65.3%). Twelv e patients (23%) presented mycotic IA secondary to bacterial endocarditis. In the remaining six patients (11.5%), IA resulted from direct contaminatio n or spreading from a contiguous infection site. Surgical treatment include d ligation of the artery without reconstruction in 19 patients and exclusio n bypass in 33 patients. The duration of antibiotic treatment ranged from 1 5 days to 3 months. No recurrence of aneurysm was observed but th ree patie nts developed bypass infection. Primary IA was associated with high mortali ty due to severe septicemia.