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Endovascular treatment for mycotic aneurysm using pyoktanin- applied devices.

PMID: 32886250 (view PubMed database entry)
DOI: 10.1186/s42155-020-00151-0 (read at publisher's website )
PMCID: PMC7474012 (free full text version available)

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Kei Kazuno, Hajime Kinoshita, Mariko Hori, Takamichi Yosizaki, Atsusi Tamura, Hiroshige Sato, Seiichiro Murata,

BACKGROUND:Mycotic thoracic aortic aneurysm is an extremely rare but serious disease because it can easily rupture and has a high mortality rate. The standard therapy for it comprises graft replacement and debridement using systemic antibiotics; nonetheless, this has a high mortality rate and complications. Endovascular aortic repair is considered a bridging therapy before open surgery. However, we have used it at our institution for the radical treatment of mycotic thoracic aortic aneurysm utilizing pyoktanin (methylrosanilide chloride)-applied devices. Thus, the aim of this study was to report our clinical experience with pyoktanin-applied thoracic endovascular aortic repair for the treatment of mycotic thoracic aortic aneurysm, including its effects. METHODS:From April 2017 to July 2019, we performed thoracic endovascular aortic repair using pyoktanin for eight cases of mycotic thoracic aortic aneurysm using Valiant®. During device preparation before insertion, pyoktanin was flushed from the side port instead of saline containing heparin. RESULTS:There were no operative deaths, recurrences of infection, or major complications. Two cases died from pneumonia and cancer; the other six cases were alive during the follow-up period. CONCLUSIONS:Pyoktanin-applied thoracic endovascular aortic repair for mycotic thoracic aortic aneurysm treatment is effective. However, the appropriate use of antibiotics and bundled therapy is necessary at present.

CVIR Endovasc (CVIR endovascular)
[2020, 3(1):55]

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