Ruptured infected aneurysm of the thoracic aorta associated with tunneled dialysis catheter-related methicillin-resistant Staphylococcus aureus bacteremia in a hemodialysis patient

Katsuragawa, Fumiko; Nagahama, Kiyotaka; Naito, Seiji; Tsuura, Yukio; Otani, Megumi; Koide, Takaaki; Nishiyama, Sakino; Yanagi, Tomoki; Nanamatsu, Azuma; Aki, Shota; Aoyagi, Makoto; Tanaka, Hiroyuki; Rai, Tatemitsu; Uchida, Shinichi

doi:10.1007/s13730-018-0352-z

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…Negative blood cultures are not enough to exclude infected aneurysm because positive blood cultures can be obtained in only 50–70% of patients with an infected aneurysm [ 2 , 3 ]. Despite report of venous and arterial infections aneurysms due to catheters [ 4 ], we could not find published works reporting infected aneurysms due to long-term implanted catheters. This was an extremely rare case of an infectious aneurysm caused by prolonged implantation of an arterial catheter.…”

Section: Introductionmentioning

confidence: 75%

“…Although there are some reports of infections and pseudoaneurysms due to catheters [ 4 ], to the best of our knowledge, no study has reported infected thoracoabdominal aneurysms that are associated with implanted long-term arterial catheters for chemotherapy. This case was a rare but extreme scenario caused by a long-term indwelling aortic catheter compounded by rare organisms responsible for the infection.…”

Section: Discussionmentioning

confidence: 99%

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Infected thoracoabdominal aortic aneurysm related to an implanted long-term arterial catheter for chemotherapy: a case report

Takemoto¹,

Nakamura²,

Sakuraya

et al. 2021

J Med Case Reports

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Background An infected aortic aneurysm is a rare and life-threatening vascular condition with a high incidence of arterial rupture and recurrence even after treatment. One of the most common causes of an infected aortic aneurysm is catheter-related bloodstream infection. Although infection due to indwelling catheters is possible, the incidence of this is rare, especially for long-term implanted arterial catheters. Case presentation A 78-year-old Japanese man with a past medical history of rectal cancer with metastasis to the liver presented to our hospital as a result of low back pain. Remission had been achieved following surgery and adjuvant chemotherapy via an implanted catheter for arterial infusion. However, the original catheter that was inserted from the femoral artery to the hepatic artery via the celiac artery was still present more than 10 years after diagnosis, without being replaced, in case of a recurrence. On the day of admission, computed tomography scan of the chest and abdomen with contrast revealed an irregularly shaped aortic aneurysm at the origin of the celiac artery and a partially expanded common hepatic artery with disproportionate fat stranding along the implanted arterial catheter without extravasation. Although the initial impression was an impending rupture of the acute thoracoabdominal aortic aneurysm, a catheter-related infection was considered as a differential diagnosis. Surgery was performed, which revealed a catheter-related infected aortic aneurysm based on images along the catheter, pus cultures, and tissue pathology examination results. Conclusions This is an extremely rare case of an infectious aneurysm caused by prolonged implantation of an arterial catheter for chemotherapy. It should be noted that an indwelling arterial catheter not only causes bloodstream infections but can also cause an infection of a thoracoabdominal aortic aneurysm.

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Section: Introductionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Infected thoracoabdominal aortic aneurysm related to an implanted long-term arterial catheter for chemotherapy: a case report

Takemoto¹,

Nakamura²,

Sakuraya

et al. 2021

J Med Case Reports

View full text Add to dashboard Cite

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Incidence of Anastomotic Pseudoaneurysm of Arteriovenous Fistula in Hemodialysis Patients Having Non-Cuffed Catheters as Vascular Access – Association or Causation?

Vyahalkar

Binnani

Kulkarni

et al. 2022

Indian Journal of Vascular and Endovascular Surgery

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Background: Anastomotic pseudoaneurysm affecting arteriovenous fistula created for hemodialysis is an unusual and catastrophic complication. There is lack of clinical data in literature about its incidence and management. Aims and Objectives: To study the incidence and understand the aetiology of anastomotic pseudoaneurysm of arteriovenous fistula (PA-AVF) occurring in first six months after surgery. Materials and Methods: Cohort study based on retrospective analysis of three-year data of case-series of PA-AVF occurring in first six months after AV fistula creation for hemodialysis. Results: Among the 283 AV fistula surgeries (215 distal forearm radio-cephalic AVF and 68 brachial artery or cubital region AVF), 7 patients (2.4%) developed PA-AVF within 1 to 8 weeks after AV fistula surgery. Over-extended dependence on non-cuffed hemodialysis (HD) catheter was a common factor among patients developing this complication. All the patients had a prolonged stay (34 to 75 days) of non-cuffed HD catheters before development of PA-AVF. Diagnosis of HD catheter-related blood stream infection (HD-CRBSI), which overlapped with development of PA-AVF, was proven in 4 patients, two of which also had surgical site infection. One patient had traumatic PA-AVF and in two patients the cause could not be established although features consistent with CRBSI were present. Excision of pseudoaneurysm and ligation of radial artery was done in all cases. Conclusion: Infection is the most common cause of anastomotic pseudoaneurysm of AV fistula. Our study points towards extended use of non-cuffed hemodialysis catehters as a risk factor for development of PA-AVF. Prevention and early aggressive management of CRBSI and surgical site infections along with a limited use of non-cuffed HD catheters for the minimum required duration is the key to reduce the incidence of this complication

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Ruptured infected aneurysm of the thoracic aorta associated with tunneled dialysis catheter-related methicillin-resistant Staphylococcus aureus bacteremia in a hemodialysis patient

Cited by 2 publications

References 16 publications

Infected thoracoabdominal aortic aneurysm related to an implanted long-term arterial catheter for chemotherapy: a case report

Infected thoracoabdominal aortic aneurysm related to an implanted long-term arterial catheter for chemotherapy: a case report

Incidence of Anastomotic Pseudoaneurysm of Arteriovenous Fistula in Hemodialysis Patients Having Non-Cuffed Catheters as Vascular Access – Association or Causation?

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