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Surgical Treatment of Mycotic Aneurysms

ROGER F. SMITH, M.D.; D. EMERICK SZILAGYI, M.D.; JAMES M. COLVILLE, M.D.
Arch Surg. 1962;85(4):663-674. doi:10.1001/archsurg.1962.01310040135015.
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Mycotic aneurysms are uncommon arterial lesions that arise as a complication of septicemia, usually that of subacute bacterial endocarditis.1,10,12 Before the advent of antimicrobial drug therapy, blood stream infections rarely healed and metastatic abscesses of the arterial wall appeared almost invariably as terminal phenomena; even if the lesions were recognized before death, the clinical course often made repair impossible or rendered the result fruitless. The loss of life and limb following surgical intervention—consisting of ligation, excision, or aneurysmorrhaphy—was high.8,13

The introduction of antibiotics profoundly changed the clinical outlook of septicemias, and with the therapeutic means at hand to sterilize the blood stream mycotic aneurysms assumed a more favorable position from the viewpoint of surgical treatment. The development of techniques of vascular replacement afforded opportunity for the surgeon to remove the aneurysm and restore arterial continuity. With the newer vascular procedures available, attempts at the cure of mycotic

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