Endovascular Repair of Mycotic Aneurysm of the Descending Thoracic Aorta

Johnstone, Jill K.; Slaiby, Jeffery M.; Marcaccio, Edward J.; Chong, Tze Tec; Garcia-Toca, Manuel

doi:10.1016/j.avsg.2012.06.004

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…[10] Once discovered, the first choice of treatment for an infected thoracic aortic aneurysm is endovascular repair, especially in high-risk patients whose mortality rates from open surgery would be prohibitive, combined with intravenous antibiotic therapy. [11] As seen in this case, findings on 18 F-FDG PET/CT may be the only indication that a mycotic aneurysm is the cause of FUO. However, 18 F-FDG PET/CT may play an additional role in the evaluation of known aneurysms in patients with suspected infection as this can alter treatment plans.…”

Section: Discussionmentioning

confidence: 53%

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18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of a rare mycotic aneurysm of the thoracic aorta in a patient with fever of unknown origin

2021

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Fever of unknown origin (FUO) is a condition with high mortality that often presents a diagnostic challenge to clinicians. We present the case of a patient with FUO who was discovered to have a rare mycotic aneurysm of the thoracic aorta by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography imaging. Mycotic aneurysm, also known as an infected aneurysm, is a highly lethal condition due to the risk of sepsis and aneurysmal rupture. While unusual to present in this manner, it is of utmost importance to promptly recognize a mycotic aneurysm as a potential diagnosis because initiation of treatment is critical in reversing the natural history of the disease.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of a rare mycotic aneurysm of the thoracic aorta in a patient with fever of unknown origin

2021

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“…In recent decades, endovascular stent graft repair has been introduced as a less invasive alternative for treating aortic aneurysms; this strategy has been extended to include infected aortic aneurysms. 1 , 2 ) Here we report a successful thoracic endovascular aortic repair (TEVAR) of an acute mycotic descending aortic pseudoaneurysm, despite a subsequent aortoesophageal fistula.…”

Section: Introductionmentioning

confidence: 99%

Successful Endovascular Repair of Mycotic Aortic Pseudoaneurysm Followed by Aortoesophageal Fistula

Yamaguchi

Ueda

Fujita

et al. 2017

Annals of Vascular Diseases

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Mycotic aneurysm of the aorta is a rare, but life-threatening pathology. In recent years, endovascular stent graft placement has been introduced as an effective alternative for treating infected aortic aneurysms. A 64-year-old woman with a history of paraplegia due to spinal cord injury was referred to our institute with fever and blood-tinged sputum. Computed tomography (CT) scan showed an 11-cm pseudoaneurysm arising from the proximal descending aorta, which was normal 1 month ago at the previous CT scan. The patient underwent thoracic endovascular aortic repair for the pseudoaneurysm, deployed with a transiliac access approach, and received antibacterial medical therapy. On postoperative day 11, she developed signs of infection, caused by an aortoesophageal fistula. The infection was treated conservatively with parenteral nutrition and antibiotic administration. The patient had an uneventful recovery and was discharged on postoperative day 113. At 2-year follow-up, she had a normal physical examination and CT angiography showed a marked reduction of the pseudoaneurysm sac. We report a successful endovascular stent grafting and subsequent medical treatment in a patient with a mycotic thoracic aortic pseudoaneurysm followed by a postoperative aortoesophageal fistula.

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“…Since the first thoracic aorta endograft device was approved by the FDA in 2005, thoracic endovascular aortic repair (TEVAR) has undergone rapid evolution and is now applied to a range of aortic pathologies, including trauma, aneurysm, dissections, intramural hematoma (IMH), penetrating atherosclerotic ulcer (PAU), and even persistent congenital malformations such as aortic co-arctation [1,2]. TEVAR has also been used as a bridge treatment before open repair in patients with aortic infections who develop circulatory collapse or fistulization to adjacent structures [3,4]. Compared with open surgical repair, TEVAR has demonstrated favorable perioperative morbidity and mortality data for many forms of thoracic aorta pathology [5].…”

Section: Summary Of Literature Review Introduction/backgroundmentioning

confidence: 99%

“…CT chest abdomen pelvis without and with IV contrast 3 See references [2][3][4][5][6][7][8][9][10][11][12][13][14]33,34,61,[71][72][73][74][75][76][77][78][79][80][81][82][83]. ☢☢☢☢ CT chest abdomen pelvis with IV contrast 3 CTA is the preferred examination.…”

mentioning

confidence: 99%

ACR Appropriateness Criteria® Thoracic Aorta Interventional Planning and Follow-Up

Bonci

Steigner

Hanley

et al. 2017

Journal of the American College of Radiology

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Endovascular Repair of Mycotic Aneurysm of the Descending Thoracic Aorta

Cited by 11 publications

References 17 publications

18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of a rare mycotic aneurysm of the thoracic aorta in a patient with fever of unknown origin

18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of a rare mycotic aneurysm of the thoracic aorta in a patient with fever of unknown origin

Successful Endovascular Repair of Mycotic Aortic Pseudoaneurysm Followed by Aortoesophageal Fistula

ACR Appropriateness Criteria® Thoracic Aorta Interventional Planning and Follow-Up

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