Open Surgical Repair Using the Femoral Vein for a Mycotic Superior Mesenteric Artery Aneurysm

Namkoong, Min; Hong, Seok Beom; Kim, Hwan Wook; Jo, Kwang Wook; Kim, Jang Yong

doi:10.5090/kjtcs.2018.51.3.209

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…The surgical resection may also include bowel resection depending on the collateralization of the bowel [1]. In cases requiring bypass, an autologous graft, for example, from the saphenous vein [9] is recommended over prosthetic conduits as they have a lower risk of secondary infection and need for further re-intervention [2]. During the surgical resection for our patient, an intraoperative Doppler confirmed the viability of the bowel, so all the bowel was preserved.…”

Section: Discussionmentioning

confidence: 91%

“…The treatment of choice is antibiotics -generally started before intervention [3] along with surgical resection of the infected aneurysm [1,4]. This is followed by a prolonged course of antibiotics for a minimum duration of 6 weeks [9]. The surgical resection may also include bowel resection depending on the collateralization of the bowel [1].…”

Section: Discussionmentioning

confidence: 99%

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Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

et al. 2021

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We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by Klebsiella pneumoniae. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive K. pneumoniae and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

et al. 2021

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“…We reviewed cases of SMA pseudoaneurysms caused by infective endocarditis published in the last decade through PubMed. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] After counting a total of 21 cases, 15 of them were treated surgically (1 of which was laparoscopic), 3 were treated with TAE, 2 were treated medically, and 1 was treated with TAE combined with a covered stent. The specific treatment usually depends on the shape and location of the aneurysm, the patency of the distal and proximal branches, the blood supply to the intestine, and the patient's current signs-the prognosis for emergency cases is usually poor.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Superior Mesenteric Artery Pseudoaneurysm Due to Infective Endocarditis With Stent-Graft

Zhou

et al. 2023

J Endovasc Ther

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Purpose: To report a successful case of pseudoaneurysm of the superior mesenteric artery (SMA) caused by infected endocarditis treated with a covered stent. Case Report: A patient was diagnosed with infective endocarditis and 2 months later a proximal SMA pseudoaneurysm was identified on computed tomography. Daptomycin was started on admission and continued for approximately 4 months until the inflammatory markers normalized, and then the SMA pseudoaneurysm was successfully excluded with a stent-graft and antibiotics were continued for 1 year after the procedure. There were no associated complications or recurrences at the 3-year follow-up. Conclusion: Placing a covered stent with a full course of antibiotics before and after surgery may be a successful alternative to open surgery in the treatment of pseudoaneurysms of the SMA due to infective endocarditis. Clinical Impact This case report reports a rare case of pseudoaneurysm of the superior mesenteric artery due to infective endocarditis, which was successfully treated with an overlapping stent and confirmed by complete imaging data at a three-year follow-up. This report suggests that endovascular treatment may be an alternative to open surgery in the treatment of pseudoaneurysms of the superior mesenteric artery caused by infective endocarditis.

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Use of Indocyanine Green During Repair of a Superior Mesenteric Artery Aneurysm

Schwarte

Sigdel

Dwivedi

et al. 2021

Annals of Vascular Surgery

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Open Surgical Repair Using the Femoral Vein for a Mycotic Superior Mesenteric Artery Aneurysm

Cited by 4 publications

References 8 publications

Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by <b><i>K. pneumoniae</i></b>

Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by <b><i>K. pneumoniae</i></b>

Endovascular Treatment of Superior Mesenteric Artery Pseudoaneurysm Due to Infective Endocarditis With Stent-Graft

Use of Indocyanine Green During Repair of a Superior Mesenteric Artery Aneurysm

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