Inam Hina, Ahad Abdul, Sundardas Rita, Shaikh Fareed Ahmed, Sharfuddin Shahabuddin, Siddiqui Nadeem Ahmed
Section of Cardiothoracic Surgery, Aga Khan University Hospital Karachi, Pakistan.
Resident Cardiothoracic Surgery, Section of Cardiothoracic Surgery, Aga Khan University Hospital Karachi, Pakistan.
Int J Surg Case Rep. 2023 Feb;103:107902. doi: 10.1016/j.ijscr.2023.107902. Epub 2023 Jan 12.
Innominate artery aneurysm (IAA) is an extremely rare fatal condition with an overall prevalence of less than 3 % of all supra-aortic artery aneurysms. These infrequent lesions usually present as an emergency and require challenging surgical procedures.
We report an interesting case of mycotic IAA in a 25 years old male patient. He was a known intravenous drug abuser having mycotic aneurysm arising from brachiocephalic artery with eccentric thrombus causing adjacent mass effect over the trachea. He underwent successful emergent surgical management of aneurysm with autologous vein graft using superficial femoral vein. Unfortunately, he died due to massive upper gastrointestinal bleeding leading to multi-organ failure after a prolonged post-operative course.
Mycotic aneurysms of the IA are extremely rare with an overall incidence of 1-2.7 % cases of all IAA. Presentation of the IAA can be quite variable from asymptomatic to symptoms exhibiting mass effect over surrounding structures. Rupture of IAA can be fatal and can occur if not treated promptly. There are no current recommendations or guidelines for treatment and interventions in IAA. Surgical management involves complete excision of the aneurysm and then revascularization.
Infected Innominate artery aneurysm is a rare surgical entity requiring early diagnosis, detailed investigation and prompt surgical management involving multidisciplinary team approach. Our case describes a relatively innovative approach to this scarce condition.
无名动脉动脉瘤（IAA）是一种极其罕见的致命疾病，在所有主动脉弓上动脉瘤中总体患病率不到3%。这些罕见病变通常表现为急症，需要具有挑战性的外科手术。
我们报告一例25岁男性患者的霉菌性IAA有趣病例。他是一名已知的静脉药物滥用者，患有源于头臂动脉的霉菌性动脉瘤，伴有偏心血栓，对气管产生相邻肿块效应。他接受了使用股浅静脉进行自体静脉移植的成功急诊动脉瘤手术治疗。不幸的是，在术后漫长病程后，他因大量上消化道出血导致多器官衰竭而死亡。
IA的霉菌性动脉瘤极其罕见，在所有IAA病例中总体发病率为1 - 2.7%。IAA的表现差异很大，从无症状到出现对周围结构有肿块效应的症状。IAA破裂可能致命，如果不及时治疗就会发生。目前尚无关于IAA治疗和干预的推荐或指南。外科治疗包括完全切除动脉瘤，然后进行血管重建。
感染性无名动脉动脉瘤是一种罕见的外科疾病，需要早期诊断、详细检查以及涉及多学科团队方法的及时外科治疗。我们的病例描述了针对这种罕见情况的一种相对创新的方法。
