Zhao Shenyu, Wang Zhe, Li Yong, Wang Hong, Zhao Yu
Department of Vascular Surgery, First Affiliated Hospital of Chongqing Medical University.
Department of Respiratory Medicine, People's Hospital of Tongliang District.
Medicine (Baltimore). 2019 Apr;98(17):e15268. doi: 10.1097/MD.0000000000015268.
We present a rare case of multiple tuberculous mycotic aneurysm. Multiple aneurysms caused by tuberculosis (TB) are difficult to treat. Here, we discuss a treatment modality using a microcore stent graft.
A 73-year-old man with pain in the back and on the right side of the chest associated with dry cough, presented with an inability to walk since 1-month.
A diagnosis of multiple aneurysms caused by TB was made, based on computed tomography (CT) scan and positive T-spot and Xpert tests.
We administered the empirical anti-TB regimen (pyrazinamide, isoniazid, rifampicin, and ethambutol) and performed endovascular repair using microcore stent graft.
The post-operative hemodynamic analysis indicated that the patient's aneurysms no longer had a risk of rupture, and blood flow in the major branches of the aorta had been maintained. However, the patient could not survive due to a pulmonary infection acquired during recuperation at a local hospital.
For multiple tuberculous mycotic aneurysms, anti-TB therapy is inadequate and the microcore stent graft is a feasible option that can improve the hemodynamics in the aneurysms.
我们报告一例罕见的多发性结核性霉菌性动脉瘤病例。由结核病（TB）引起的多发性动脉瘤难以治疗。在此，我们讨论一种使用微芯支架移植物的治疗方式。
一名73岁男性，背部和右侧胸部疼痛伴干咳，自1个月前起出现行走困难。
基于计算机断层扫描（CT）、结核感染T细胞检测（T-spot）和Xpert检测呈阳性，诊断为结核引起的多发性动脉瘤。
我们给予经验性抗结核治疗方案（吡嗪酰胺、异烟肼、利福平、乙胺丁醇），并使用微芯支架移植物进行血管内修复。
术后血流动力学分析表明，患者的动脉瘤不再有破裂风险，主动脉主要分支的血流得以维持。然而，患者因在当地医院康复期间获得的肺部感染而未能存活。
对于多发性结核性霉菌性动脉瘤，抗结核治疗并不充分，微芯支架移植物是一种可行的选择，可以改善动脉瘤内的血流动力学。
