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.
Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, the Netherlands.
Kirsten
K
Kuizenga
Michel M P J
MM
Reijnen
Ignace F J
IF
Tielliu
Eric L G
EL
Verhoeven
Jan J A M
JJ
van den Dungen
Clark J
CJ
Zeebregts
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