Combined Open and Endovascular Repair of Multiple Aortic Aneurysms due to Syphilitic Aortitis
Shima, S.; Okamura, K.; Morizumi, S.; Kawata, M.; Suematsu, Y.
Kyobu Geka. Japanese Journal of Thoracic Surgery 68(6): 426-430
2015
ISSN/ISBN: 0021-5252 PMID: 26066872 Document Number: 681750
The patient was a 69-year-old man who presented with low-grade fever and appetite loss. Thoracoabdominal computed tomography revealed multiple aneurysms in the distal arch and descending thoracic and infrarenal aortic regions combined with a right common iliac artery aneurysm. After endovascular stent grafting for a right iliac artery aneurysm, he underwent total arch replacement and open stent grafting for the descending thoracic aneurysms. Pathological microscopic examination revealed an inflammatory infiltrate within the adventitia and destruction of the elastic fibers in the media, which are classical features of syphilitic aortitis. Endovascular aneurysm repair is contraindicated in mycotic infected aneurysms. However, endovascular repair is useful for treating mycotic infected aneurysm, if multiple aneurysms have the possibility of rupture and a high risk of surgery.