Endovascular repair of aortic rupture due to Brucella aortitis

Abstract

Brucellosis is a zoonosis, caused by bacteria belonging to the genus Brucella. Aortic involvement is a rare complication, often following embolization from infective endocarditis. However, contiguous propagation from vertebral involvement may occur. We report the case of an 81 year old patient abruptly presenting with aortic rupture due to Brucella melitensis infection. The diagnosis of aortic rupture was made by CT. The patient underwent urgent endovascular treatment using endoprosthesis deployment in the abdominal aorta and iliac arteries. Long term antibiotic treatment was given. Resolution of the acute event was obtained without further surgical treatment. 18 months after endovascular treatment, the patient remains in good health.

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

“…According to the diagnostic algorithm proposed by the European Society of Cardiology (ESC) guidelines, all patients with a clinical suspicion of IE underwent a first complete transthoracic echocardiography (TTE) using the Siemens AcusonSC 2000 ultrasound system prime echocardiography machine (Siemens AG, Munich, Germany), equipped with a 2.5-3.5 MHz probe within one week from the admission to the emergency unit of the University Hospital [23]. Transesophageal echocardiography (TEE) using the iE 33 echocardiographic Philips Medical System (Veenpluis, The Netherlands) was always performed in all TTE with low-quality imaging, valve prosthesis implantation, and cardiac implantable electronic devices (CIED) at the cardiosurgical unit of "Paolo Giaccone" University Hospital in Palermo as previously reported [24][25][26]. All echocardiographic investigations were performed according to the criteria stated in the Duke classification and discussed at the MDT meetings [2].…”

Combined Thoracic Endovascular Aortic Repair and Neurosurgical Intervention for Injury Due to Posterior Spine Surgery

“…Endovascular stenting to repair iliac vessel injuries complicating spinal surgery has been previously well described . Thoracic endovascular aortic repair (TEVAR), first described by Dake in 1994, currently represents a first option strategy for many patients with a thoracic aortic pathology . The use of TEVAR in aortic trauma has contributed to a reduction of both mortality and morbidity mainly due to the incidence of postoperative respiratory failure and paraplegia seen after open aortic surgery …”

“…[17][18][19][20] Thoracic endovascular aortic repair (TEVAR), first described by Dake in 1994, currently represents a first option strategy for many patients with a thoracic aortic pathology. [21][22][23][24][25][26] The use of TEVAR in aortic trauma has contributed to a reduction of both mortality and morbidity mainly due to the incidence of postoperative respiratory failure and paraplegia seen after open aortic surgery. [27][28][29][30][31][32][33][34][35] Thoracic endografting allows the repair of focal aortic perforations with a low incidence of endoleak or graft migration that would need a secondary intervention.…”

Acute brucellosis associated with isolated splenic and left gastric artery vasculitis and acute ischemic bowel infarction. A systematic review of the most recent cases

“…After exposure to Brucella, humans generally have a two to four week latency period before exhibiting symptoms, which include acute undulating fever (>90% of all cases), headache, arthralgia (>50%), night sweats, fatigue, and anorexia [3]. Few case reports addressed potential vascular involvement during the disease course of brucellosis [1,[4][5][6][7][8][9][10][11][12][13]. Aortitis is the most commonly reported vascular affection in brucellosis [4][5][6].…”

“…Few case reports addressed potential vascular involvement during the disease course of brucellosis [1,[4][5][6][7][8][9][10][11][12][13]. Aortitis is the most commonly reported vascular affection in brucellosis [4][5][6]. In brucellosis, different types of vasculitis have been reported infrequently, such as leukocytoclastic vasculitis (LCV), which refers to small blood vessel inflammation, recurrent panniculitis, mixed cryoglobulinemia with renal failure, cutaneous vasculitis and peritonitis, celiac artery (CA) and superior mesenteric artery (SMA) vasculitis, and thrombosis of the inferior vena cava (IVC) [1,[7][8][9][10][11][12].…”