Page 19 - Virtual Vascular Vol 16

Axial scan images showing the defect in the aortic
wall typical of a mycotic aneurysm. This is very dif-
ferent from the appearance of a degenerated infra-
renal aneurysm. Most of the time Salmonella is the
culprit.

While traditional treatment is surgical excision, wide
debridement, and extra-anatomical revascularization
of the low aorta, it has given way to endovascular
stent graft exclusion with life-long antibiotics. While
not always successful (especially with purulent or-
ganisms, malignancy, aorto-enteric fistulation) the
endovascular approach has gained increasing sup-
port and often effective in sick patients.

19