Follow-up evaluation of endoluminally treated abdominal aortic aneurysms with duplex ultrasonography: Validation with computed tomography

Infectious abdominal aortic aneurysms often present with abdominal and lower back pain, but prolonged fever may be the only symptom. Infectious abdominal aortic aneurysms initially presenting with meningitis are extremely rare; there are no reports of their successful treatment. Cases withStreptococcus pneumoniaeas the causative bacteria are even rarer with a higher mortality rate than those caused by other bacteria. We present the case of a 65-year-old man with lower limb weakness and back pain. Examination revealed fever and neck stiffness. Cerebrospinal fluid showed leukocytosis and low glucose levels. The patient was diagnosed with meningitis and bacteremia caused byStreptococcus pneumoniaeand treated with antibiotics. Fever, inflammatory response, and neurologic findings showed improvement. However, abdominal computed tomography revealed an aneurysm not present on admission. Antibiotics were continued, and a rifampicin soaked artificial vascular graft was implanted. Tissue cultures showed no bacteria, and histological findings indicated inflammation with high leukocyte levels. There were no postoperative complications or neurologic abnormalities. Physical examination, blood tests, and computed tomography confirmed there was no relapse over the following 13 months. This is the first reported case of survival of a patient with an infectious abdominal aortic aneurysm initially presenting with meningitis caused byStreptococcus pneumoniae.

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Endovascular repair of thoraco-abdominal aortic aneurysms by fenestrated and branched endografts†

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz125 ◽

2019 ◽

Vol 56 (5) ◽

pp. 993-1000 ◽

Cited By ~ 5

Author(s):

Enrico Gallitto ◽

Gianluca Faggioli ◽

Rodolfo Pini ◽

Chiara Mascoli ◽

Stefano Ancetti ◽

...

Keyword(s):

Spinal Cord ◽

Hospital Mortality ◽

Endovascular Repair ◽

Endovascular Aneurysm Repair ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Abdominal Aortic ◽

The Mean ◽

Aneurysm Repair

Abstract OBJECTIVES Our objective was to report the outcomes of fenestrated/branched endovascular aneurysm repair of thoraco-abdominal aortic aneurysms (TAAAs) with endografts. METHODS Between January 2010 and April 2018, patients with TAAAs, considered at high surgical risk for open surgery and treated by Cook-Zenith fenestrated/branched endovascular aneurysm repair, were prospectively enrolled and retrospectively analysed. The early end points were 30-day/hospital mortality rate, spinal cord ischaemia and 30-day cardiopulmonary and nephrological morbidity. Follow-up end points were survival, patency of target visceral vessels and freedom from reinterventions. RESULTS Eighty-eight patients (male: 77%; mean age: 73 ± 7 years; American Society of Anesthesiologists 3/4: 58/42%) were enrolled. Using Crawford’s classification, 43 (49%) were types I–III and 45 (51%) were type IV TAAAs. The mean aneurysm diameter was 65 ± 15 mm. Custom-made and off-the-shelf endografts were used in 60 (68%) and 28 (32%) cases, respectively. Five (6%) patients had a contained ruptured TAAA. The procedure was performed in multiple steps in 42 (48%) cases. There was 1 (1%) intraoperative death. Five (6%) patients suffered spinal cord ischaemia with permanent paraplegia in 3 (3%) cases. Postoperative cardiac and pulmonary complications occurred in 7 (8%) and 12 (14%) patients, respectively. Worsening of renal function (≥30% of baseline level) was detected in 11 (13%) cases, and 2 (2%) patients required haemodialysis. The 30-day and hospital mortality rates were 5% and 8%, respectively. The mean follow-up was 36 ± 22 months. Survival at 12, 24 and 36 months was 89%, 75% and 70%, respectively. The patency of target visceral vessels at 12, 24 and 36 months was 92%, 92% and 92%, respectively. Freedom from reinterventions at 12, 24 and 36 months was 85%, 85% and 83%, respectively. CONCLUSIONS The endovascular repair of TAAAs with fenestrated/branched endovascular aneurysm repair is feasible and effective with acceptable technical/clinical outcomes at early/midterm follow-up.

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Prospective follow-up of sexual function after elective repair of abdominal aortic aneurysms using open and endovascular techniques

Journal of Vascular Surgery ◽

10.1016/j.jvs.2009.02.245 ◽

2009 ◽

Vol 50 (3) ◽

pp. 492-499 ◽

Cited By ~ 25

Author(s):

Monica Pettersson ◽

Erney Mattsson ◽

Ingegerd Bergbom

Keyword(s):

Sexual Function ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Endovascular Techniques ◽

Abdominal Aortic ◽

Elective Repair

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Improvements in Rupture Prediction of Abdominal Aortic Aneurysms Using Local Mechanical Property Estimation Obtained From ECG-Gated Computed Tomography

ASME 2010 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2010-19431 ◽

2010 ◽

Author(s):

Áine Tierney ◽

Anthony Callanan ◽

Tim M. McGloughlin

Keyword(s):

Computed Tomography ◽

Abdominal Aortic Aneurysms ◽

Common Type ◽

Aortic Aneurysms ◽

Diagnostic Tools ◽

The Past ◽

Property Estimation ◽

Abdominal Aortic ◽

The Us ◽

Local Mechanical Property

Cardiovascular disease concerns any disease which affects the heart or blood vessels. Aneurysms account for a significant portion of these cardiovascular diseases. The most common type of aneurysm is abdominal aortic aneurysm (AAA) which affects up to 5% of the population over the age of 55. AAA is a focal balloon like dilation of the terminal aorta that occurs gradually over a span of years [1]. There are approximately 200,000 patients in the US and 500,000 patients worldwide diagnosed with AAA each year [2]. The incidences of AAA’s has increased largely during the past two decades due in part to the aging demographic, the rise in the number of smokers, the introduction of screening programmes and improved diagnostic tools [3].

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