title: Treatment of a mycotic descending thoracic aortic aneurysm using endovascular stent-graft placement and rifampin infusion with postoperative aspiration of the aneurysm sac.
abstract: OBJECTIVE
  Mycotic aortic aneurysms are rare but are associated with high morbidity and mortality due to their propensity for rupture. Traditional therapy consists of open surgical repair with resection and aortic reconstruction or extra-anatomic bypass combined with long-term antibiotic therapy.
  
  
  METHODS
  An 85-year-old male with persistent bacteremia was found to have a descending mycotic aortic aneurysm. Surgical options were discussed and endovascular treatment was recommended with stent-graft placement followed by intra-aortic rifampin infusion. This approach led to resolution of the aneurysm and eradication of bacteremia at 4-month follow-up.
  
  
  CONCLUSIONS
  By combining traditional surgical strategies with a contemporary endovascular approach, the perioperative mortality and long-term risk of infection associated with mycotic thoracic aneurysms can potentially be decreased.
authors.affiliation: Department of General Surgery, Mayo Clinic Florida, Jacksonville, FL 32224, USA.
authors.forename: Cameron D
authors.initials: CD
authors.lastname: Adkisson
authors.forename: W Andrew
authors.initials: WA
authors.lastname: Oldenburg
authors.forename: Erol V
authors.initials: EV
authors.lastname: Belli
authors.forename: Adam S
authors.initials: AS
authors.lastname: Harris
authors.forename: Eric M
authors.initials: EM
authors.lastname: Walser
authors.forename: Albert G
authors.initials: AG
authors.lastname: Hakaim
mesh_terms: D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D003131:Combined Modality Therapy; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012293:Rifampin / Q000008:administration & dosage*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D015607:Stents; D013396:Suction; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D012293:Rifampin