title: Embolization of a Large Rapidly Growing Aortic Pseudo-Aneurysm Not Amenable to Open or Endovascular Repair.
abstract: BACKGROUND
  To report the case of a rapidly growing aortic false aneurysm because of Q fever infection that was managed by embolization.
  
  
  METHODS
  An 80-year-old man was admitted to our unit for an aortic false aneurysm from a chronic Q fever infection. During his stay, the aneurysm showed rapid progression necessitating urgent treatment. The patient was unfit for surgical repair; moreover, the location of the aneurysm at the level of the superior mesenteric artery prohibited the use of an endovascular graft. He was managed by coiling of the aneurysmal cavity with multiple detachable coils after positioning of a bare aortic stent to lock the coils and prevent their migration into the aortic lumen. The false aneurysm was successfully thrombosed with no complications. The patient was then put on doxycycline and hydroxychloroquine to target Coxiella burnetii.
  
  
  CONCLUSIONS
  Aortic false aneurysm coiling is feasible in cases where an endograft is not possible or an open repair is contraindicated. The use of a bare metal stent may help as a barrier to prevent the coils from migrating into the aneurysm and thus avoiding embolization into the systemic circulation.
authors.affiliation: Department of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: gino.gemayel@hcuge.ch.
authors.forename: Gino
authors.initials: G
authors.lastname: Gemayel
authors.affiliation: Department of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Parmeseeven
authors.initials: P
authors.lastname: Mootoosamy
authors.affiliation: Department of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Murith
authors.affiliation: Department of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Afksendiyos
authors.initials: A
authors.lastname: Kalangos
mesh_terms: D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D001027:Aortography / Q000379:methods; D001431:Bacteriological Techniques; D000072226:Computed Tomography Angiography; D016997:Coxiella burnetii / Q000302:isolation & purification*; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004621:Embolization, Therapeutic; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008297:Male; D011778:Q Fever / Q000175:diagnosis / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D006886:Hydroxychloroquine; D004318:Doxycycline