Emergency endovascular treatment of early spontaneous nonaneurysmal popliteal artery rupture in a patient with Salmonella bacteremia

Trellopoulos, George; Georgiadis, George S.; Kapoulas, Konstantinos; Pitta, Xanthi; Zervidis, Ioannis; Lazarides, Miltos K.

doi:10.1016/j.jvs.2010.04.031

Cited by 14 publications

(8 citation statements)

References 33 publications

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“…The cases reported in the literature are summarized in Supplementary Table S1 (refs. 22 – 56 ). The clinical features of the 4 cases treated at our hospital and the 53 cases reported in the literature are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Mycotic aneurysm due to Salmonella species: clinical experiences and review of the literature

Guo

Bai

Yang

et al. 2018

Braz J Med Biol Res

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The mortality of patients with mycotic aneurysms is high, especially in East Asia, and infection by Salmonella species is the most common. Our study aimed to improve prognosis of adult mycotic aneurysms with early diagnosis and accurate treatment. Four adult patients with mycotic aneurysm caused by Salmonella were included and analyzed by single-center retrospective analysis. Cases reported in the literature during the past 10 years were also summarized. The average age of the 4 male patients was 61.25 years, while that of the 53 cases reported in the literature was 65.13 years. Hypertension, diabetes, and atherosclerosis were common complications. Most patients presented fever and experienced pain at the corresponding position of the aneurysm. Laboratory examination found an increased number of white blood cells accompanied by an increase in inflammatory markers. Most aneurysms were found in the abdominal aorta, while the rupture of an aneurysm was the most common complication. The mortality rates were 21.43 and 7.14% after open surgery or endovascular aneurysm repair (EVAR) intervention, respectively. The recurrence rates of infection were 0 and 17.85% for both treatments, respectively. The mortality rate of mycotic aneurysm caused by Salmonella infection was high in middle-aged males with hypertension, diabetes, and atherosclerosis. The possibility of a Salmonella-infected aneurysm should be considered in these high-risk groups presenting chills, fever, chest, and back pain. Open surgery was superior to EVAR treatment in the clearance of infected foci and the reduction of postoperative recurrence. The recurrence of postoperative infection can be prevented by intravenous antibiotic therapy for 6 weeks post-surgery.

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Section: Resultsmentioning

confidence: 99%

Mycotic aneurysm due to Salmonella species: clinical experiences and review of the literature

Guo

Bai

Yang

et al. 2018

Braz J Med Biol Res

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“…The commonest locations of non-typhoidal Salmonella mycotic aneurysms in the elderly include the abdominal aorta, followed by the thoracic aorta and then the iliofemoral artery [4] . Popliteal artery mycotic aneurysms secondary to non-typhoidal Salmonella (S. enteritidis being the most commonly implicated serovar) have been rarely reported in case reports, presenting predominantly with fever and leg swelling [5] , as with our patient.…”

Section: Discussionmentioning

confidence: 80%

“…Riga et al described five high-risk patients with peripheral infected aneurysms who were successfully treated by endovascular stenting [6] . Trellopoulos et al reported the first case of a patient with S. enteritidis bacteraemia, who had spontaneous rupture of the popliteal artery and was successfully treated by endovascular repair with a covered stent [5] . To the best of our knowledge, our patient is the second reported case.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Mycotic Popliteal Aneurysm Presenting as Recurrent Salmonella enteritidis Bacteraemia

Zheng

Lee

2017

European Journal of Case Reports in Internal Medicine

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We describe a patient with a Salmonella enteritidis mycotic aneurysm. A 91-year-old man presented with recurrent episodes of S. enteritidis bacteraemia 2 months apart. During the second presentation, he underwent magnetic resonance imaging of the left lower limb that revealed rupture of the popliteal artery with a popliteal fossa collection. This was aspirated and cultures grew S. enteritidis. He underwent endovascular stenting and received a prolonged course of antibiotics. Popliteal artery mycotic aneurysm should be considered as a differential in patients presenting with unilateral painful leg swelling and bacteraemia from microorganisms with a propensity for endovascular infections.LEARNING POINTSOur case illustrates a rare and unusual entity of ruptured popliteal mycotic aneurysm in an otherwise common scenario of recurrent nontyphoidal salmonellosis.In patients with recurrent Salmonella bacteraemia, clinicians often perform computed tomography scans to look for extraintestinal sites of involvement; however, this frequently misses any peripherally sited aneurysms, which often do not manifest with any early clinical symptoms.

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“…Transesophageal echocardiogram revealed absent valve vegetation with no significant valve dysfunction. The possibility of Salmonella endarterial infection was ruled out by negative blood cultures, and the absence of an antecedent clinical picture suggestive of bacteremia [ 6 ]. One etiology that has been described as a cause of pseudoaneurysms is connective tissue disorders [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Anterior Tibial Artery Avulsion and Tibio-Peroneal Trunk Transection Resulting into a Pseudoaneurysm: A Case Report

et al. 2017

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Patient: Female, 53Final Diagnosis: Spontaneous non-traumatic anterior tibial artery avulsion and tibio-peroneal trunk transectionSymptoms: PainMedication: —Clinical Procedure: Autogenous popliteal-tibioperoneal trunk bypassSpecialty: SurgeryObjective:Rare diseaseBackground:Popliteal fossa pseudoaneurysms as a result of trauma are not uncommon. However, spontaneous pseudoaneurysms as a result of non-traumatic rupture of posterior tibial artery (PTA), anterior tibial artery (ATA), or tibioperoneal trunk (TPT) artery segment are extremely rare. We report a case of spontaneous popliteal fossa pseudoaneurysm resulting from spontaneous avulsion of the ATA and transection of the TPT. Despite a thorough workup, no underlying associated disease was found. The extreme rarity of this disease presentation prompted us to report this case.Case Report:A 53-year-old female patient presented with a 10-day history of sudden onset of non-traumatic left popliteal fossa pain and swelling. A popliteal fossa pseudoaneurysm was diagnosed by duplex ultrasound examination. Computed tomography angiography (CTA) was performed to confirm the diagnosis and to plan treatment. Surgical exploration revealed avulsion of the ATA and transection of the TPT leading to a pseudoaneurysm. Autogenous popliteal-tibioperoneal trunk bypass was performed with uneventful recovery.Conclusions:A spontaneous popliteal fossa pseudoaneurysm caused by non-traumatic ATA avulsion and complete transection of TPT is extremely rare. Yet, it can be the cause of limb loss if not recognized early and treated promptly. Awareness by the medical community will help reduce the potential morbidity associated with this condition.

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Emergency endovascular treatment of early spontaneous nonaneurysmal popliteal artery rupture in a patient with Salmonella bacteremia

Cited by 14 publications

References 33 publications

Mycotic aneurysm due to Salmonella species: clinical experiences and review of the literature

Mycotic aneurysm due to Salmonella species: clinical experiences and review of the literature

An Unusual Case of Mycotic Popliteal Aneurysm Presenting as Recurrent Salmonella enteritidis Bacteraemia

Spontaneous Anterior Tibial Artery Avulsion and Tibio-Peroneal Trunk Transection Resulting into a Pseudoaneurysm: A Case Report

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