Endovascular repair of Salmonella-infected abdominal aortic aneurysms: A word of caution

Forbes, Thomas L.; Harding, Gregory E.J.

doi:10.1016/j.jvs.2006.03.002

Cited by 50 publications

(41 citation statements)

References 20 publications

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“…However, although outcome up to 2 years appears favorable in those without evidence of fever, aneurysm rupture or fistulation, the long-term outcome remains uncertain (19)(20)(21)(22), Moreover, higher graft reinfection rates have been reported in the setting of Salmonella species (23,24) and long-term immunosuppression (25), which were additional reasons for not pursuing this approach in our case.…”

Section: Discussionmentioning

confidence: 78%

Infectious Aortitis in a Liver Transplant Recipient

Gerada

Ganeshanantham

Dawwas

et al. 2013

American Journal of Transplantation

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Section: Discussionmentioning

confidence: 78%

Infectious Aortitis in a Liver Transplant Recipient

Gerada

Ganeshanantham

Dawwas

et al. 2013

American Journal of Transplantation

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“…The current approach may be the control of bleeding with an endovascular graft, followed by definite reconstruction (3,11,12). Therefore, reports on endovascular treatment of mycotic aneurysms are being seen more commonly recently (4,7,8,13). The mortality rate of endovascular repair (EVAR) was significantly lower than open surgery (11).…”

Section: Discussionmentioning

confidence: 99%

A real mycotic aneurysm-mycotic aneurysm of the abdominal aorta due to fungal infection

Tıhan

Aksoy

2014

UCD

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A 53-year-old male who was being followed up by a nephrology department because of type V crescentic glomerulonephritis was admitted with abdominal pain to our clinic. He was diagnosed with abdominal aortic aneurysm after the examinations. Aortic repair with a tubular graft was performed. Pathological examination of the aneurysm tissue showed fungal hyphae. We started antifungal chemotherapy with amphotericin B. A separation of the graft body occurred, and the patient was reoperated on. An excision of the graft, ligation of the aorta, and axillobifemoral graft by-pass was performed. At the 15 th month of his discharge, the patient was readmitted to the emergency room of our clinic suffering from hematemesis. According to the examinations, an aortoduodenal fistula was diagnosed, and we performed a partial duodenal resection and end-to-end duodenoduodenostomy. We want to share this unusual, interesting, and complicated case, operated on several times because of a mycotic aneurysm due to a fungal infection.

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“…21 One author even reported Salmonella infection flare-up years after treatment. 21 In our case, intravenous cefotaxime was used for 1 month, and ciprofloxacin for another 5 months and then stopped based on clinical judgment.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of a nontraumatic left subclavian artery pseudoaneurysm

Chen¹,

Su²,

Liu³

et al. 2012

Journal of the Chinese Medical Association

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Mycotic subclavian artery pseudoaneurysms are rare. There are controversies over the surgical or endovascular approach as the treatment of choice for these lesions. The standard surgical debridement might not be a choice for poorly surgically reachable lesions or for patients with multiple comorbidities. Endovascular aneurysm repair may be an effective alternative in selected cases. This treatment was rarely reported previously. Herein, we present a high-surgical-risk case with a highly suspected left subclavian arterial mycotic pseudoaneurysm, which, although difficult to approach surgically, was successfully managed with stent grafting and a complete antibiotic treatment course. An 89-year-old male was admitted due to intermittent fever and hemoptysis for 2 months. Salmonella group B was cultured from his sputum, and a 3.5 cm pseudoaneurysm was identified by chest multidetector-row computed tomography (MDCT) angiogram. Endovascular treatment with a graft stent was chosen due to high surgical risk and difficult surgical access to the lesion. The intervention was well planned ad hoc, based on MDCT images and meticulously performed by dual endovascular approaches. Antibiotics were continued after the procedure, and the patient was discharged from the hospital. As MDCT disclosed near-complete regression of the pseudoaneurysms 2 months later and the patient was in healthy status, antibiotics were continued for 6 months. He was readmitted 11 months later due to lacunar infarction with minor pneumonia over the left lower lung in which Salmonella enteritis was also diagnosed. After this acute event, he was again hospitalized 14 days later due to sepsis with adult respiratory distress syndrome and shortly expired despite all emergent treatment measures. No evidence of local subclavian infection recurrence was noted throughout or related to subsequent events. In conclusion, endovascular treatment of an infected subclavian artery pseudoaneurysm could be a choice in selected patients, but treatment of underlying infection determines the clinical outcome.

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Endovascular repair of Salmonella-infected abdominal aortic aneurysms: A word of caution

Cited by 50 publications

References 20 publications

Infectious Aortitis in a Liver Transplant Recipient

Infectious Aortitis in a Liver Transplant Recipient

A real mycotic aneurysm-mycotic aneurysm of the abdominal aorta due to fungal infection

Endovascular treatment of a nontraumatic left subclavian artery pseudoaneurysm

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