Subscribe to RSS
DOI: 10.1055/s-0032-1322618
Endovascular Repair of Mycotic Aneurysm of the Descending Thoracic Aorta: Diagnostic and Therapeutic Dilemmas—Two Case Reports with 1-Year Follow-Up
Publication History
08 March 2012
06 April 2012
Publication Date:
06 December 2012 (online)
![](https://www.thieme-connect.de/media/thoracic/201307/lookinside/thumbnails/10.1055-s-0032-1322618-1.jpg)
Abstract
A mycotic aneurysm of the thoracic aorta is a rare diagnosis with high mortality. We present two cases of endovascular reconstruction of mycotic descending thoracic aorta. Specific or nonspecific bacterial or other infectious agent in serial samples of blood, urine, cerebrospinal fluid, and pleural puncture was not detected in the first case, but we found in sputum sample Mycobacterium tuberculosis in the second patient. We empirically began by administering broad-spectrum intravenous antibiotics in the first case, with preoperative antibiotic prophylaxis and antituberculotic drugs therapy in the second case, and continued with the same medication for 4 months after endovascular repair. Control computed tomographic scans 6 months after reconstruction showed no endoleak in both patients. Repair of mycotic descending thoracic aortic aneurysms by endoluminal stent graft is reasonable alternative to open surgical intervention. A broad-spectrum antibiotic therapy has a high significance in the treatment of patients with mycotic aneurysm.
-
References
- 1 Oderich GS, Panneton JM, Bower TC , et al. Infected aortic aneurysms: aggressive presentation, complicated early outcome, but durable results. J Vasc Surg 2001; 34 (5) 900-908
- 2 Chan FY, Crawford ES, Coselli JS, Safi HJ, Williams Jr TW. In situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann Thorac Surg 1989; 47 (2) 193-203
- 3 Müller BT, Wegener OR, Grabitz K, Pillny M, Thomas L, Sandmann W. Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases. J Vasc Surg 2001; 33 (1) 106-113
- 4 Murphy DP, Glazier DB, Krause TJ. Mycotic aneurysm of the thoracic aorta caused by Clostridium septicum. Ann Thorac Surg 1996; 62 (6) 1835-1837
- 5 Kyriakides C, Kan Y, Kerle M, Cheshire NJ, Mansfield AO, Wolfe JHN. 11-year experience with anatomical and extra-anatomical repair of mycotic aortic aneurysms. Eur J Vasc Endovasc Surg 2004; 27 (6) 585-589
- 6 Dugdale DC, Stevens DL, Knight LL. Mycotic aneurysm and disseminated Mycobacterium avium-intracellulare infection in a patient with hairy cell leukemia. West J Med 1989; 150 (2) 207-208
- 7 Maundrell J, Fletcher S, Roberts P, Stein A, Lambie M. Mycotic aneurysm of the aorta as a complication of Bacillus Calmette-Guérin instillation. J R Coll Physicians Edinb 2011; 41 (2) 114-116
- 8 Takahashi Y, Tsutsumi Y, Monta O, Ohashi H. Mycotic aneurysm of the thoracic aorta caused by extended-spectrum beta-lactamase-producing Escherichia coli. Interact Cardiovasc Thorac Surg 2011; 12 (1) 61-62