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左心室辅助装置感染继发霉菌性颅内动脉瘤

Mycotic Intracranial Aneurysm Secondary to Left Ventricular Assist Device Infection.

作者信息

Remirez Juan M, Sabet Yasmin, Baca Marshall, Maud Alberto, Cruz-Flores Salvador, Rodriguez Gustavo J, Mukherjee Debabrata, Abbas Aamer

机构信息

Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.

Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.

出版信息

J Vasc Interv Neurol. 2017 Jan;9(3):23-25.

Abstract

BACKGROUND

Mycotic aneurysms are a complication of infective endocarditis. Infection of left ventricular assist devices (LVADs) may lead to bacteremia and fever causing complications similar to those seen in patients with prosthetic valve endocarditis. Intracranial mycotic aneurysms are rare, and their presence is signaled by the development of subarachnoid hemorrhage in the setting of bacteremia and aneurysms located distal to the circle of Willis.

CASE PRESENTATION

We present the case of a patient with a LVAD presenting with headache who is found to have an intracranial mycotic aneurysm through computed tomography angiography of the head. The patient was successfully treated with endovascular intervention.

CONCLUSION

In patients with LVADs, mycotic aneurysms have been reported, however not intracranially. To the best of our knowledge, this is the first intracranial mycotic aneurysm secondary to LVAD infection that was successfully treated with endovascular repair. Intracranial mycotic aneurysms associated with LVADs are a rare phenomenon. The diagnosis of mycotic aneurysms requires a high index of suspicion in patients who present with bacteremia with or without headache and other neurological symptoms.

DISCLOSURE

None.

摘要

背景

霉菌性动脉瘤是感染性心内膜炎的一种并发症。左心室辅助装置(LVAD)感染可能导致菌血症和发热,引发与人工瓣膜心内膜炎患者类似的并发症。颅内霉菌性动脉瘤较为罕见,其存在通过在菌血症背景下蛛网膜下腔出血以及位于 Willis 环远端的动脉瘤来提示。

病例介绍

我们报告一例植入 LVAD 的患者,因头痛就诊,通过头部计算机断层血管造影发现颅内霉菌性动脉瘤。该患者通过血管内介入治疗获得成功。

结论

在植入 LVAD 的患者中,已有霉菌性动脉瘤的报道,但并非颅内动脉瘤。据我们所知,这是首例继发于 LVAD 感染且通过血管内修复成功治疗的颅内霉菌性动脉瘤。与 LVAD 相关的颅内霉菌性动脉瘤是一种罕见现象。对于出现菌血症且伴有或不伴有头痛及其他神经症状的患者,霉菌性动脉瘤的诊断需要高度怀疑指数。

披露

无。

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本文引用的文献

1
Ventricular assist device related infections and solid organ transplantation.
Am J Transplant. 2013 Mar;13 Suppl 4:348-54. doi: 10.1111/ajt.12126.
2
Fifth INTERMACS annual report: risk factor analysis from more than 6,000 mechanical circulatory support patients.
J Heart Lung Transplant. 2013 Feb;32(2):141-56. doi: 10.1016/j.healun.2012.12.004.
3
TEVAR for ruptured mycotic aneurysm in a patient with a left ventricular assist device.
J Endovasc Ther. 2012 Jun;19(3):370-2. doi: 10.1583/12-3821R.1.
4
Intracranial infectious aneurysms: a comprehensive review.
Neurosurg Rev. 2010 Jan;33(1):37-46. doi: 10.1007/s10143-009-0233-1. Epub 2009 Oct 16.
5
Ventricular assist device-related infections.
Lancet Infect Dis. 2006 Jul;6(7):426-37. doi: 10.1016/S1473-3099(06)70522-9.
6
Mycotic aneurysm. New concepts in therapy.
Arch Surg. 1983 May;118(5):577-82. doi: 10.1001/archsurg.1983.01390050053010.

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