title: Antineutrophil Cytoplasmic Antibody-Associated Multiple Giant Saccular Aortic Aneurysms.
abstract: We describe a very rare case of a 67-year-old man with multiple saccular aortic aneurysms throughout the entire aorta due to antineutrophil cytoplasmic antibody-associated vasculitis (AAV). The patient underwent staged aortic surgical procedures, including stent-graft insertion for a left iliac artery aneurysm, thoracic endovascular aortic repair for a descending aortic aneurysm, and total replacement of the ascending aorta and aortic arch with the use of high-dose steroids to control inflammation. The histologic findings demonstrated that the damage to the vasa vasorum of the adventitia resulting from AAV caused ischemia of the media, resulting in the formation of saccular aneurysmal changes.
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kinoshita
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: t-mizuno@yhc.att.ne.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Mizuno
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hachimaru
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Oi
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yashima
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Eiki
authors.initials: E
authors.lastname: Nagaoka
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hidehito
authors.initials: H
authors.lastname: Kuroki
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Tasaki
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Arai
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods*; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications* / Q000175:diagnosis; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000276:immunology* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D000072226:Computed Tomography Angiography / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D035583:Rare Diseases; D018570:Risk Assessment; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods