Stent-graft repair of a mycotic left subclavian artery pseudoaneurysm.
OBJECTIVE
To report successful stent-graft treatment of a mycotic pseudoaneurysm of the left subclavian artery in an immunosuppressed patient.


METHODS
A 17-year-old immunosuppressed woman undergoing treatment for recurrent leukemia developed persistent fever and 2 episodes of hemoptysis. A contrast-enhanced computed tomographic (CT) scan demonstrated a saccular aneurysm of the left subclavian artery, which was considered to be a mycotic aneurysm caused by erosive fungal infection from the lung. The pseudoaneurysm was treated with a homemade stent-graft consisting of a nitinol stent and a polyester fabric. A type II endoleak present at the end of the procedure appeared to have sealed spontaneously on the CT scan at 3 days. No neurological deficit or ischemic symptoms of the left arm were noted during the follow-up, which lasted until the patient died 11 months later after rejecting a second bone marrow transplant.


CONCLUSIONS
Endovascular repair may be an alternative to open surgery for the management of mycotic aneurysms of the subclavian artery.
Sanada
Junichiro
J
Department of Radiology, Kanazawa University School of Medicine, Japan. sanadaj@rad.m.kanazawa-u.ac.jp
Matsui
Osamu
O
Terayama
Noboru
N
Kobayashi
Satoshi
S
Minami
Tetsuya
T
Chujo
Tatsuya
T
Urayama
Hiroshi
H
D000293:Adolescent; D000497:Alloys; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D009181:Mycoses / Q000150:complications*; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D000497:Alloys; C013616:nitinol