Endovascular Treatment of a Symptomatic Mycotic Aneurysm of the Peroneal Artery

Ferrero, Emanuele; Ferri, Michelangelo; Carbonatto, Paolo; Viazzo, Andrea; Robaldo, Alessandro; Calvo, A.; Pecchio, Alberto; Berardi, Giuseppe; Piazza, Salvatore; Cumbo, Pia; Nessi, Franco

doi:10.1016/j.avsg.2011.03.012

Cited by 6 publications

(13 citation statements)

References 8 publications

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“…Manifestations of SPMAs at the extremities include pulsatile painful masses, ischemia secondary to thrombosis or rupture, splinter hemorrhages or ischemic lesions due to digital embolization, 6 , 17 , 19 , 24 , 30 , 32 , 33 , 37 , 40 , 45 , 48 , 52 , 57 , 58 , 67 and neurologic symptoms and signs due to direct compression or occlusion of the vasa nervorum. 30 , 40 , 51 Presentation may also mimic a deep vein thrombosis in popliteal SPMA.…”

Section: Discussionmentioning

confidence: 99%

“…6 , 17 , 36 Percutaneous endovascular management of noninfectious visceral artery aneurysms is now considered a safe and effective alternative to conventional surgery, with lower procedural morbidity and mortality and high technical success rates, but its role in infectious aneurysms has yet to be defined. In the last decades endovascular repair of PMAs due to IE has been reported in intraabdominal PMAs by embolization associated with stent implantation, 2 , 18 , 25 , 56 in limbs generally by embolization plus stent grafting, 19 , 32 , 52 and in coronary PMAs using stent. 62 The outcomes were favorable with no relapse or rebleeding, as in the current patient with hepatic SPMA.…”

Section: Discussionmentioning

confidence: 99%

“… 44 They are mainly located in the branches of intracranial arteries, 4 but have also been described in intraabdominal arteries, 2 , 3 , 18 , 25 – 27 , 35 , 41 , 43 , 56 , 61 , 63 coronary arteries, 39 , 46 , 47 , 54 , 62 and limbs. 6 , 17 , 19 , 24 , 30 , 32 , 33 , 37 , 40 , 45 , 48 , 52 , 57 , 58 …”

Section: Introductionmentioning

confidence: 99%

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Symptomatic Peripheral Mycotic Aneurysms Due to Infective Endocarditis

et al. 2014

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Peripheral mycotic aneurysms (PMAs) are a relatively rare but serious complication of infective endocarditis (IE). We conducted the current study to describe and compare the current epidemiologic, microbiologic, clinical, diagnostic, therapeutic, and prognostic characteristics of patients with symptomatic PMAs (SPMAs). A descriptive, comparative, retrospective observational study was performed in 3 tertiary hospitals, which are reference centers for cardiac surgery. From 922 definite IE episodes collected from 1996 to 2011, 18 patients (1.9%) had SPMAs. Because all SPMAs developed in left-sided IE, we performed a comparative study between 719 episodes of left-sided IE without SPMAs and 18 episodes with SPMAs.We found a higher frequency of intravenous drug abuse, native valve IE, intracranial bleeding, septic emboli, multiple embolisms, and IE diagnostic delay >30 days in patients with SPMAs than in patients without SPMAs. The causal microorganisms were gram-positive cocci (n =10), gram-negative bacilli (n = 2), gram-positive bacilli (n = 3), Bartonella henselae (n = 1), Candida albicans (n = 1), and negative culture (n = 1). The median IE diagnosis delay was 15 days (interquartile range [IQR], 13–33 d) in the case of high-virulence microorganisms versus 45 days (IQR, 30–240 d) in the case of low- to medium-virulence microorganisms. Twelve SPMAs were intracranial and 6 were extracranial. In 10 cases (8 intracranial and 2 extracranial), SPMAs were the initial presentation of IE; the remaining cases developed symptoms during or after finishing parenteral antibiotic treatment. The initial diagnosis of intracranial SPMAs was made by computed tomography (CT) or magnetic resonance imaging in 6 unruptured aneurysms and by angiography in 6 ruptured aneurysms. The initial test in extracranial SPMAs was Doppler ultrasonography in limbs, CT in liver, and coronary angiography in heart. Four (3 intracranial, 1 extracranial) of 7 (6 intracranial, 1 extracranial) patients treated only with antibiotics died. Surgical resection was performed in 7 (3 intracranial, 4 extracranial) and endovascular repair in 4 (3 intracranial, 1 extracranial) patients; all of them survived.In conclusion, we found that SPMAs were a rare complication of IE that developed only in left-sided IE, and especially in native valves. Intracranial hemorrhage, embolism, multiple embolisms, and diagnostic delay of IE were more common in patients with SPMAs. The microbiologic profile was diverse, but microorganisms of low-medium virulence were predominant, and had a greater delayed diagnosis of IE than those caused by microorganisms of high virulence. SPMAs were often the initial presentation of IE. The most common location of SPMAs was intracranial. Noninvasive radiologic imaging techniques were the initial imaging test in intracranial unruptured SPMAs and in most extracranial SPMAs. Surgical and endovascular treatments were safe and effective. Endovascular treatment could be the first line of treatment in selected cases. Mortality was high in those cases...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Symptomatic Peripheral Mycotic Aneurysms Due to Infective Endocarditis

et al. 2014

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“…Five cases of peroneal artery aneurysm of mycotic aetiology have been described in the literature and are summarised below. [6][7][8][9][10] Ferrero et al reported a 69-year old man with a sudden onset of pain in the right calf without signs of leg ischaemia. 6 The diagnosis of a mycotic peroneal artery aneurysm was made based on the unusual location of the aneurysm, clinical presentation and positive blood cultures.…”

Section: Discussionmentioning

confidence: 99%

Bilateral peroneal artery aneurysms

et al. 2017

annals

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True aneurysm of the tibial arteries is a rare clinical condition. We report the case of a 67-year-old man who presented with a gradual onset of right calf swelling and pain. Imaging revealed large aneurysms arising from the proximal peroneal arteries bilaterally, measuring 7.4cm and 4cm on the right and left respectively. A detailed medical history, clinical examination and laboratory investigations did not identify evidence of an underlying cause. A surgical reconstruction with an interposition vein graft was successfully performed. To our knowledge, this is the first reported case of primary aneurysm of the peroneal artery in the English literature. We undertook a systematic literature review to identify all reported cases of primary aneurysms of the tibial arteries. The clinical presentation, modes of investigation and interventional treatments are discussed.

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“…Mycotic aneurysms can be found in any artery of the body, but are most commonly found in the aorta and carotid arteries 4 . Mycotic peroneal artery aneurysms (MPAAs) are rare and are limited to case reports 3, 4, 5, 6, 7. We present a case of symptomatic MPAA in a patient with fungal endocarditis.…”

mentioning

confidence: 98%

Open surgical ligation of a symptomatic mycotic aneurysm of the peroneal artery

Silver

Ferranti

Radtka

2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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A mycotic peroneal artery aneurysm (MPAA) is a rare diagnosis. We describe a case of a patient with active fungal endocarditis who developed right lower extremity pain. Imaging demonstrated that this patient had an MPAA. This was treated with open ligation of the peroneal artery, and decompression of the aneurysm sac was performed for symptom relief. Although a rare diagnosis, MPAA should be considered in patients with a history of endocarditis who present with leg pain.

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Endovascular Treatment of a Symptomatic Mycotic Aneurysm of the Peroneal Artery

Cited by 6 publications

References 8 publications

Symptomatic Peripheral Mycotic Aneurysms Due to Infective Endocarditis

Symptomatic Peripheral Mycotic Aneurysms Due to Infective Endocarditis

Bilateral peroneal artery aneurysms

Open surgical ligation of a symptomatic mycotic aneurysm of the peroneal artery

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