Syphilitic aneurysms of the innominate artery.

Abstract

Syphilitic aortitis can cause formation of fusiform or saccular aneurysms of the ascending aorta or transverse arch. The authors report 3 cases in which a saccular aneurysm developed at the origin of the innominate artery and was seen as a mediastinal mass on the chest radiograph.

Giant syphilitic aortic aneurysm: A case report and review of the literature

“…8 Syphilitic vasculitis and aneurysmal disease affecting the abdominal aorta, 9 pulmonary arteries, 10 coronary arteries, 11 and aortic arch branch vessels have also been reported. 12 Large syphilitic thoracic aortic aneurysms may cause symptoms via mass effect on neighboring mediastinal structures, including the trachea, esophagus and pulmonary artery, [13][14][15] as in our patient. Additional reported complications include compression of the superior vena cava, 16 erosion into the chest wall 17 and thoracic spinal bodies, 18 erosion into the airways 19 and esophagus, 20 and fistulization to the pulmonary artery.…”

“…8 Syphilitic vasculitis and aneurysmal disease affecting the abdominal aorta, 9 pulmonary arteries, 10 coronary arteries, 11 and aortic arch branch vessels have also been reported. 12…”

Innominate artery aneurysm with hemoptysis and airway compression in a patient with bovine aortic arch

“…Most IA aneurysms are of arteriosclerotic origin, as was the case presented, but they can also be caused by traumatic injury, infection, syphilis, connective tissue disease, or vasculitis. 2,[8][9][10][11] These lesions are usually diagnosed in asymptomatic patients, although they can present life-threatening complications, such as stroke, transient ischemic accidents, ischemia or embolism of the upper extremities, compressive symptoms (chest pain, dyspnea, dysphagia, hoarseness, superior vena cava syndrome), and even rupture. [12][13][14] Rupture is uncommon and mainly occurs in post-traumatic aneurysms 8 and those associated with connective tissue disease.…”

Tracheal compression caused by an innominate artery aneurysm after thoracic aortic aneurysm repair in a patient with Marfan disease

“…Innominate artery aneurysms are rare and described in relation to atherosclerosis 6 or syphilis 7 and, to a lesser extent, to Takayasu disease, trauma, chronic dissection, bacterial infection, and collagen disorders. 8 Three percent of the total number of cases of aneurysms correspond to aneurysms of the innominate artery.…”

“…4,5 Innominate artery aneurysms are even more uncommon than anomalies and are mainly described in relation to atherosclerosis 6 or Treponema pallidum infection. 7 We report the case of a patient with Marfan disease and repeated sternotomy for aortic arch surgery in whom difficult weaning after repair of a thoracoabdominal aortic aneurysm led to the diagnosis of severe tracheal compression caused by an innominate artery aneurysm. Reoperation with exclusion of the aneurysm and transection of fibrotic tissue compromising the patency of the trachea improved tracheal stenosis and led to complete resolution of symptoms after successful extubation.…”