scholarly journals Serial PET-CT Scans Can Help Determine Duration of Antibiotic Therapy After Endovascular Mycotic Thoracic Aortic Aneurysm Repair

2019 ◽  
Vol 11 ◽  
pp. 117906521986768
Author(s):  
Jonathan Weissmann ◽  
Ali Shnaker ◽  
Shadi Mahajna ◽  
Moanis Ajaj ◽  
Simone Fajer
Keyword(s):  
Aortic Aneurysm ◽  
Antibiotic Therapy ◽  
Ct Scans ◽  
Endovascular Interventions ◽  
Positron Emission ◽  
Pet Ct ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair ◽  
Prolonged Antibiotic Therapy

Mycotic aortic aneurysm is a rare vascular condition, with high-risk for fatal complications. In cases of bacterial infection, prolonged antibiotic therapy is administered. There is no consensus on duration of antibiotic therapy and close follow-up is recommended following surgical and endovascular interventions. We report a case of a patient, who was diagnosed with mycotic aneurysm and underwent successful endovascular repair. Extended postoperative antibiotic treatment was administered. The duration was determined by sequential Fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) scans over a period of 6 months.

scholarly journals Acute Calculous Cholecystitis Missed on Computed Tomography and Ultrasound but Diagnosed with Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

2016 ◽  
Vol 6 ◽  
pp. 31 ◽  
Author(s):  
Carina Mari Aparici ◽  
Aung Zaw Win
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Aortic Aneurysm ◽  
Clinical Symptoms ◽  
Emission Tomography ◽  
Low Grade ◽  
Positron Emission ◽  
Pet Ct ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT) showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results.

Sealing zones have a greater influence than iliac anatomy on the occurrence of limb occlusion following endovascular aortic aneurysm repair

Vascular ◽  
2015 ◽  
Vol 24 (3) ◽  
pp. 279-286 ◽  
Author(s):  
Anne Daoudal ◽  
Alain Cardon ◽  
Jean-Philippe Verhoye ◽  
Elodie Clochard ◽  
Antoine Lucas ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Aortic Aneurysm ◽  
External Iliac Artery ◽  
P Value ◽  
Endovascular Aortic Aneurysm Repair ◽  
Aortic Neck ◽  
Occlusion Rate ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Limb occlusion is a well-known complication following endovascular aortic aneurysm repair (EVAR), and it very often leads to reoperation. The aim of this study is to identify predictive factors for limb occlusion following EVAR. Two hundred and twenty-four patients undergoing EVAR between 2004 and 2012 were included in this retrospective study. Demographics, anatomic, and follow-up data were compared between two groups (with or without thrombosis). Preoperative anatomy was analyzed with a dedicated workstation, using the Society of Vascular Surgery reporting standards. Eleven (4.9%) patients presented with a limb occlusion during follow-up (46 ± 12 months). Univariate analyses were first performed to investigate the influence of preoperative variables on limb occlusion. Then, variables with a p value <0.1 were included in the multivariate analysis and showed that in the occlusion group there was a greater rate of chronic renal failure (18.2% vs. 3.8%, p = 0.012), a more frequent occurrence of distal landing zones in the external iliac artery (15.4% vs. 2.1%, p = 0.006), and a smaller aortic neck diameter (21.0 ± 2.9 mm vs. 23.6 ± 3.3 mm, p = 0.014). Although iliac anatomy does not appear to have a significant influence on limb occlusion rate in the multivariate analysis, proximal and distal sealing zones appear to be involved in this complication.

Large Iliac Arteries: A High-Risk Group for Endovascular Aortic Aneurysm Repair

2007 ◽  
Vol 14 (5) ◽  
pp. 625-629 ◽  
Author(s):  
Ciaran O. McDonnell ◽  
James B. Semmens ◽  
Yvonne B. Allen ◽  
Shirley J. Jansen ◽  
D. Mark Brooks ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Iliac Artery ◽  
High Risk Group ◽  
Consecutive Series ◽  
Type Ii ◽  
Secondary Intervention ◽  
Iliac Arteries ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Purpose: To examine if the presence of large iliac arteries is a potential risk factor for the development of a type Ib endoleak (iliac sealing zone) or need for iliac artery—related secondary intervention in patients undergoing endovascular abdominal aortic aneurysm repair. Methods: The medical notes and all preoperative and postoperative plain abdominal radiographs and computer tomographic scans were reviewed for a consecutive series of 100 patients (89 men; mean age 75 years, range 56–91) with large iliac arteries (mean 19.7 mm, range 16–22) who had Zenith endovascular stent-grafts inserted for management of aortoiliac aneurysmal disease from January 1999 until September 2002. Endpoints were all-cause mortality, aneurysm-related death, endoleak, secondary intervention, secondary interventions, and stent-graft migration. Results: Mean follow-up was 30.1±8.3 months; at the last follow-up, 30% of patients were dead, 3% were aneurysm-related. Seven (7%) patients developed a type Ib endoleak, with the remainder being type II (29%), type Ia (2%), type III (1%), and type V (endotension, 1%). Eight (27.5%) type II endoleaks persisted, with the remainder closing spontaneously with sac shrinkage. The iliac artery—related secondary intervention rate was 10%, and the overall secondary intervention rate was 16%. Conclusion: Iliac arteries between 16 and 22 mm in diameter may be treated with a cuff to the iliac limb with an expectation of 90% efficacy. Surveillance is required, with a high index of suspicion for type 1b endoleaks. Early secondary iliac intervention with extension to the external iliac artery is recommended if there is an increase in sac size after 6 months.

Longer Patient Travel Times Associated with Decreased Follow-Up after Endovascular Aortic Aneurysm Repair (EVAR)

2017 ◽  
Vol 83 (8) ◽  
pp. 339-341
Author(s):  
Andrew D. Morris ◽  
Joshua E. Preiss ◽  
Samuel Ogbuchi ◽  
Shipra Arya ◽  
Yazan Duwayri ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Travel Times ◽  
Endovascular Aortic Aneurysm Repair ◽  
Patient Travel ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

A Dedicated Surveillance Program Improves Compliance with Endovascular Aortic Aneurysm Repair Follow-up

2017 ◽  
Vol 44 ◽  
pp. 59-66 ◽  
Author(s):  
Jade Cohen ◽  
Akila Pai ◽  
Timothy M. Sullivan ◽  
Peter Alden ◽  
Jason Q. Alexander ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Surveillance Program ◽  
Endovascular Aortic Aneurysm Repair ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Duplex Ultrasound Surveillance After Uncomplicated Endovascular Abdominal Aortic Aneurysm Repair

2017 ◽  
Vol 51 (5) ◽  
pp. 295-300 ◽  
Author(s):  
Jacob S. Schaeffer ◽  
Irina Shakhnovich ◽  
Kyle N. Sieck ◽  
Kara J. Kallies ◽  
Clark A. Davis ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Predictive Value ◽  
Duplex Ultrasound ◽  
Abdominal Aortic Aneurysm Repair ◽  
Ultrasound Scan ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Objectives: Health-care costs and risks of radiation and intravenous contrast exposure challenge computed tomography angiography (CTA) as the standard surveillance method after endovascular abdominal aortic aneurysm repair (EVAR). We reviewed our experience using Duplex ultrasound scan (DUS) as an initial and subsequent surveillance technique after uncomplicated EVAR. Methods: The medical records of patients who underwent EVAR from 2004 to 2014 with at least 1 postoperative imaging study were retrospectively reviewed. Duplex ultrasound scan was the primary modality, with CTA reserved for patients with suspicious findings. Results: Mean follow-up was 3.2 years for 266 patients. Fifty-seven endoleaks (7 type I, 50 type II) were detected in 51 patients (19%). Nineteen (33%) endoleaks were identified and monitored by DUS alone. Nine (16%) endoleaks were identified on CTA without prior DUS. Twenty-two (39%) endoleaks were identified on DUS and confirmed by CTA; 6 of these patients had a secondary intervention. When compared to subsequent CTA, there were 7 discordant results: 4 false-negative and 3 false-positive endoleaks on DUS. Two of these patients with discordant results required intervention. Follow-up CTA was not obtained for the other 2 patients due to severe comorbidities including renal disease. One of these patients eventually developed abdominal aortic aneurysm rupture and death. Among 88 patients with both DUS and CTA, positive predictive value and negative predictive value for DUS were 0.88 and 0.94, respectively. Sac size on DUS compared to CTA resulted in an interclass correlation coefficient of r = .84. Conclusions: In our experience, DUS was safe and effective for initial and follow-up surveillance after uncomplicated EVAR.

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