Imaging findings, diagnosis, and clinical outcomes in patients with mycotic aneurysms: single center experience

  • Amy R. Deipolyi
    Division of Vascular and Interventional Radiology, Department of Radiology, New York University Medical Center, New York, NY
    Search for articles by this author
  • Alexander Bailin
    Massachusetts General Hospital, Harvard Medical School, Vascular and Interventional Radiology, Boston, MA
    Search for articles by this author
  • Ali Khademhosseini
    Biomaterials Innovation Research Center, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA

    Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA

    Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
    Search for articles by this author
  • Rahmi Oklu
    Corresponding author. Mayo Clinic, Division of Vascular and Interventional Radiology, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA. Tel.: +1-480-342-1650.
    Biomaterials Innovation Research Center, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA

    Mayo Clinic, Division of Vascular and Interventional Radiology, Scottsdale, AZ
    Search for articles by this author
Published:December 08, 2015DOI:



      To review the presentation, imaging, clinical management, and outcomes in patients with mycotic aneurysm (MA).


      Fifty-five cases in 49 patients (33 men, 16 women, average age: 66.2 years) were identified.


      Of 49 patients, only 20% presented with the classic clinical triad of fever, elevated white count, and pain. Computed tomography was the most utilized imaging modality; focal vascular outpouching was the most frequent imaging finding (76%). There was 17% mortality rate within 6 months of diagnosis despite intervention.


      Clinical presentation and blood cultures can be nonspecific, highlighting the importance of imaging diagnosis of MA to expedite treatment.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Chan FY
        • Crawford ES
        • Coselli JS
        • Safi HJ
        • Williams TW
        In situ prosthetic graft replacement for mycotic aneurysm of the aorta.
        Ann Thorac Surg. 1989; 47: 193-203
        • Muller BT
        • Wegener OR
        • Grabitz K
        • Pillny M
        • Thomas L
        • Sandmann W
        Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases.
        J Vasc Surg. 2001; 33: 106-113
        • Oderich GS
        • Panneton JM
        • Bower TC
        • Cherry KJ
        • Rowland CM
        • Noel AA
        • et al.
        Infected aortic aneurysms: aggressive presentation, complicated early outcome, but durable results.
        J Vasc Surg. 2001; 34: 900-908
        • Fillmore AJ
        • Valentine RJ
        Surgical mortality in patients with infected aortic aneurysms.
        J Am Coll Surg. 2003; 196: 435-441
        • Kyriakides C
        • Kan Y
        • Kerle M
        • Cheshire NJ
        • Mansfield AO
        • Wolfe JH
        11-Year experience with anatomical and extra-anatomical repair of mycotic aortic aneurysms.
        Eur J Vasc Endovasc Surg. 2004; 27: 585-589
        • Garb M
        Appendicitis: an unusual cause of infected abdominal aortic aneurysm.
        Australas Radiol. 1994; 38: 68-69
        • Parkhurst GF
        • Dekcer JP
        Bacterial aortitis and mycotic aneurysm of the aorta: a report of twelve cases.
        Am J Pathol. 1955; 31: 821-835
        • Rubery PT
        • Smith MD
        • Cammisa FP
        • Silane M
        Mycotic aortic aneurysm in patients who have lumbar vertebral osteomyelitis. A report of two cases.
        J Bone Joint Surg Am. 1995; 77: 1729-1732
        • Jorna FH
        • Verhoeven EL
        • Bos WT
        • Prins TR
        • Dol JA
        • Reijnen MM
        Treatment of a ruptured thoracoabdominal aneurysm with a stent-graft covering the celiac axis.
        J Endovasc Ther. 2006; 13: 770-774
        • Kan CD
        • Lee HL
        • Yang YJ
        Outcome after endovascular stent graft treatment for mycotic aortic aneurysm: a systematic review.
        J Vasc Surg. 2007; 46: 906-912
        • Stanley BM
        • Semmens JB
        • Lawrence-Brown MM
        • Denton M
        • Grosser D
        Endoluminal repair of mycotic thoracic aneurysms.
        J Endovasc Ther. 2003; 10: 511-515
        • Clare CE
        • Barrow DL
        Infectious intracranial aneurysms.
        Neurosurg Clin N Am. 1992; 3: 551-566
        • Reddy DJ
        • Ernst CB
        Infected aneurysms.
        in: Rutherford RB Vascular surgery. WB Saunders, Philadelphia1995: 1139-1153
        • Lee WK
        • Mossop PJ
        • Little AF
        • Fitt GJ
        • Vrazas JI
        • Hoang JK
        • et al.
        Infected (mycotic) aneurysms: spectrum of imaging appearances and management.
        Radiographics. 2008; 28: 1853-1868
        • Buckmaster MJ
        • Curci JA
        • Murray PR
        • Liao S
        • Allen BT
        • Sicard GA
        • et al.
        Source of elastin-degrading enzymes in mycotic aortic aneurysms: bacteria or host inflammatory response?.
        Cardiovasc Surg. 1999; 7: 16-26
        • Okamoto T
        • Akaike T
        • Suga M
        • Tanase S
        • Horie H
        • Miyajima S
        • et al.
        Activation of human matrix metalloproteinases by various bacterial proteinases.
        J Biol Chem. 1997; 272: 6059-6066
        • Potempa J
        • Watorek W
        • Travis J
        The inactivation of human plasma alpha 1-proteinase inhibitor by proteinases from Staphylococcus aureus.
        J Biol Chem. 1986; 261: 14330-14334
        • Stengel A
        • Wolferth CC
        Mycotic (bacterial) aneurysms of intravascular origin.
        Arch Intern Med. 1923; 31: 527-554
        • Mandell G
        • Bennett J
        • Dolin R
        Mandell, Douglas, and Bennett’s principles and practice of infectious diseases.
        Churchill Livingstone, 2010