Ruptured Infected Popliteal Artery Aneurysm

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

“…In our review, however, 40% of mycotic infected popliteal artery aneurysms attributable to Salmonella spp presented with rupture. 5,9 In addition to the risk of rupture being higher for infected than for noninfected aneurysms, Salmonella arteritis evolves rapidly to arterial rupture. 5 Transmural sepsis with wall destruction and spontaneous rupture of the popliteal artery occurred in our patient very early after Salmonella bacteremia, confirming this clinical experience.…”

“…5,9,13,16 An endoluminal infection occasionally involves preexisting true aneurysms, but this type of infective aneurysm normally results from circulating septic emboli from a remote site that lodge in the aneurysm wall. 16,22 Although various sites of the arterial tree may be involved, the infrarenal aorta is the preferred location of microbial arteritis 10,23 and is far more vulnerable to mycotic aneurysm formation, 10,20,24 which is the most serious of all extraintestinal complications.…”

“…Furthermore, a wide array of conditions, including atherosclerotic disease, diabetes, hypertension, rheumatoid arthritis, malignancy, intra-arterial administration of illicit drugs, immunocompromised hosts, especially patients with AIDS, are important risk factors for salmonellosis. 1,4,13,[17][18][19][20] The predilection of Salmonella-induced bacteremia for compromised tissues such as endothelia, although very rare, represents a genesis for arterial infected aneurysms 4,5,14,20 (Table). [5][6][7][8][9] Brown et al 10 reported 1 patient with popliteal involvement among 180 mycotic arterial aneurysms, whereas Jebara et al 21 attributed only 4 of 33 cases of popliteal artery mycotic aneurysms to the growth of Salmonella.…”

“…1,4,13,[17][18][19][20] The predilection of Salmonella-induced bacteremia for compromised tissues such as endothelia, although very rare, represents a genesis for arterial infected aneurysms 4,5,14,20 (Table). [5][6][7][8][9] Brown et al 10 reported 1 patient with popliteal involvement among 180 mycotic arterial aneurysms, whereas Jebara et al 21 attributed only 4 of 33 cases of popliteal artery mycotic aneurysms to the growth of Salmonella. To our knowledge, our patient is the first case of a spontaneous popliteal artery rupture due to Salmonella infection that was treated by endovascular methods.…”

“…1,3,4 Peripheral foci in lower limb arteries have also been described, 1 and in extremely rare cases, the popliteal artery may be involved. [5][6][7][8][9] Clinical symptoms of enteritis infection lasting from days to weeks, combined with fever and chills, usually precede the microbial arteritis attributed to Salmonella spp. 1 In this article, we describe the first report in the literature, to our knowledge, of a patient with spontaneous rupture of a nonaneurysmal popliteal artery infected with S enteritidis, complicated by acute compartment syndrome.…”