Conventional or endovascular treatment of ongoing mycotic aortic aneurysmal disease?
We report a case in which conventional and endovascular exclusion techniques were used to treat ongoing mycotic aortic aneurysmal disease. A 51-year-old man presented with an infrarenal mycotic aortic aneurysm that was excluded and reconstructed with a superficial femoral vein. Two years later, he developed a symptomatic mycotic aneurysm of the descending thoracic aorta, which required emergent treatment with a stent graft. The patient died 5 months later of massive bleeding owing to an aortobronchial fistula deriving from a new thoracic aneurysm proximal to the stent graft. Choices and different modes of treatment are discussed. Endovascular treatment of symptomatic mycotic aortic aneurysm might provide a valid alternative to open repair but may be unsuccessful owing to ongoing infection. In situ replacement using autologous material seems appealing whenever feasible.
Kuizenga
Kirsten
K
Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, the Netherlands.
Reijnen
Michel M P J
MM
Tielliu
Ignace F J
IF
Verhoeven
Eric L G
EL
van den Dungen
Jan J A M
JJ
Zeebregts
Clark J
CJ
D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000209:etiology; D019917:Blood Vessel Prosthesis Implantation; D001983:Bronchial Fistula / Q000209:etiology; D017809:Fatal Outcome; D005268:Femoral Vein / Q000637:transplantation; D005402:Fistula / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D012086:Reoperation; D015607:Stents