Shahi Niti, Kwon Jeontaik J, Arosemena Mariano, Salvatore Dawn M, DiMuzio Paul J, Abai Babak
Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
Vasc Endovascular Surg. 2016 Aug;50(6):373-9. doi: 10.1177/1538574416655894. Epub 2016 Jul 15.
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.
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.
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.
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.
动脉霉菌性破裂是一种罕见但致命的疾病。目前的治疗通常包括开放手术修复。然而，血管内修复是一种潜在的治疗方法，可用于推迟开放修复，特别是在急性不稳定患者中。通过病例报告和文献回顾来确定血管内治疗是否可作为感染继发动脉破裂患者的最终治疗方法。
我们报告了一例72岁男性患者，因沙门氏菌感染继发左髂总动脉瘤破裂，初次就诊时接受了血管内治疗。对PubMed进行文献回顾，发现29例主动脉和髂动脉感染性动脉瘤破裂患者最初接受了血管内修复治疗。
大多数患者（76.7%，30例中的(23)例）通过血管内治疗成功治愈，无需进行开放翻修。这些患者通常需要长期使用抗生素。
文献回顾支持使用覆膜支架进行血管内修复，作为紧急情况下感染性破裂动脉的临时措施，在某些情况下，也可作为最终治疗方法。
