Niti Shahi1, Jeontaik J Kwon1, Mariano Arosemena1, Dawn M Salvatore1, Paul J DiMuzio1, Babak Abai2. 1. Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA. 2. Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA babak.abai@jefferson.edu.
Abstract
OBJECTIVE: Mycotic rupture of the arteries is a rare but deadly disorder. Current management typically involves open surgical repair. However, endovascular repair is a potential treatment that can be used to delay open repair, especially in acutely unstable patients. A case report and review of the literature was conducted to determine whether endovascular therapy could be a destination therapy for patients with arterial rupture secondary to infection. METHODS: We present the case of a 72-year-old man with a left common iliac artery aneurysm rupture secondary to Salmonella infection treated with endovascular therapy upon initial presentation. A literature review of PubMed yielded 29 patients with ruptured aortic and iliac infected aneurysms that were initially treated with endovascular repair. RESULTS: Majority of the patients (76.7%, 23 of 30) were successfully treated with the endovascular treatment and did not require open revision. These patients were often placed on long-term antibiotics. CONCLUSION: The literature review supports endovascular repair with a stent graft as a temporizing measure for infected ruptured arteries in an emergent setting and, in select cases, as a destination therapy.
OBJECTIVE: Mycotic rupture of the arteries is a rare but deadly disorder. Current management typically involves open surgical repair. However, endovascular repair is a potential treatment that can be used to delay open repair, especially in acutely unstable patients. A case report and review of the literature was conducted to determine whether endovascular therapy could be a destination therapy for patients with arterial rupture secondary to infection. METHODS: We present the case of a 72-year-old man with a left common iliac artery aneurysm rupture secondary to Salmonella infection treated with endovascular therapy upon initial presentation. A literature review of PubMed yielded 29 patients with ruptured aortic and iliac infected aneurysms that were initially treated with endovascular repair. RESULTS: Majority of the patients (76.7%, 23 of 30) were successfully treated with the endovascular treatment and did not require open revision. These patients were often placed on long-term antibiotics. CONCLUSION: The literature review supports endovascular repair with a stent graft as a temporizing measure for infected ruptured arteries in an emergent setting and, in select cases, as a destination therapy.
Authors: Muzammil H Syed; Mark Wheatcroft; Danny Marcuzzi; Hooman Hennessey; Mohammad Qadura Journal: Medicina (Kaunas) Date: 2021-06-14 Impact factor: 2.430