title: Successful Endovascular Repair of a Penetrating Aortic Ulcer in Bacterial Aortitis.
abstract: Infective aortitis (IA) and penetrating aortic ulcer (PAU) impending for rupture represent 2 hostile life-threatening conditions. Simultaneous presentations of these rare entities can be considered an exception. The pleomorphic clinical presentation and the multifactorial etiology require a multidisciplinary approach to reach a correct diagnosis and an urgent treatment. We report the case of a 65-year-old patient presented with acute abdominal pain and septic shock secondary to a bacterial aortitis and penetrating ulcer of abdominal aorta. Unfit for surgery due to severe comorbidities, he was treated by means of a tubular endograft and long-term antibiotic therapy. A rapid improvement of clinical conditions was observed during the subsequent hospital stay. Complete regression of aortic involvement was demonstrated after 1 year. In conclusion, for selected patients affected by IA and PAU an endovascular approach associated to long-term antibiotic therapy may be safe and effective.
authors.affiliation: Department of Vascular Surgery, University Hospital of Verona, Verona, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Mezzetto
authors.affiliation: Department of Vascular Surgery, University Hospital of Verona, Verona, Italy. Electronic address: gianfranco.veraldi@ospedaleuniverona.it.
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Veraldi
authors.affiliation: Department of Surgery, Ospedale Regionale di Lugano, Lugano, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Engelberger
authors.affiliation: Department of Surgery, Ospedale Regionale di Lugano, Lugano, Switzerland.
authors.forename: Luca
authors.initials: L
authors.lastname: Giovannacci
authors.affiliation: Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland.
authors.forename: Josua
authors.initials: J
authors.lastname: Van den Berg
authors.affiliation: Department of Surgery, Ospedale Regionale di Lugano, Lugano, Switzerland.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Rosso
mesh_terms: D015746:Abdominal Pain / Q000382:microbiology; D059787:Acute Pain / Q000382:microbiology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001025:Aortitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D000072078:Positron Emission Tomography Computed Tomography; D012772:Shock, Septic / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents