title: [Combined Open and Endovascular Repair of Multiple Aortic Aneurysms due to Syphilitic Aortitis].
abstract: The patient was a 69-year-old man who presented with low-grade fever and appetite loss. Thoracoabdominal computed tomography revealed multiple aneurysms in the distal arch and descending thoracic and infrarenal aortic regions combined with a right common iliac artery aneurysm. After endovascular stent grafting for a right iliac artery aneurysm, he underwent total arch replacement and open stent grafting for the descending thoracic aneurysms. Pathological microscopic examination revealed an inflammatory infiltrate within the adventitia and destruction of the elastic fibers in the media, which are classical features of syphilitic aortitis. Endovascular aneurysm repair is contraindicated in mycotic infected aneurysms. However, endovascular repair is useful for treating mycotic infected aneurysm, if multiple aneurysms have the possibility of rupture and a high risk of surgery.
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, Tsukuba, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Shima
authors.forename: Kennichi
authors.initials: K
authors.lastname: Okamura
authors.forename: Sei
authors.initials: S
authors.lastname: Morizumi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kawata
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Suematsu
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000209:etiology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology / Q000601:surgery*; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D015607:Stents; D013589:Syphilis, Cardiovascular / Q000601:surgery*; D019616:Thoracic Surgical Procedures; D014057:Tomography, X-Ray Computed