Ischaemia of the medullary cone after stent-graft implantation in a patient with abdominal aortic aneurysm – a case study

In 2008 the overall rate of death attributable to cardiovascular disease, or CVD, is 244.8 per 100,000. On the basis of these mortality rate data, one American dies due to CVD on an average of every 39 seconds. Of these deaths, abdominal aortic aneurysm (AAA) accounts for 11,079 [1]. Although an estimate of the total economic burden of AAA is not available, the average cost per discharge for a ruptured AAA exceeded $93,000 in 2003 [2]. Generally, an abdominal aortic aneurysm (AAA) is an irreversible focal dilation of an artery to 1.5 times its normal diameter [3]. AAAs are characterized by the destruction of elastin and collagen in the media and adventitia, smooth muscle cell loss with thinning of the medial wall, infiltration of lymphocytes and macrophages, and neovascularization [4, 5].

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Faculty Opinions recommendation of One-year multicenter results of 100 abdominal aortic aneurysm patients treated with the Endurant stent graft.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13397958.14767058 ◽

2011 ◽

Author(s):

Jon Matsumura ◽

Gale Tang

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Stent Graft ◽

Abdominal Aortic ◽

One Year

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Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report

Medicina ◽

10.3390/medicina57060620 ◽

2021 ◽

Vol 57 (6) ◽

pp. 620

Author(s):

Muzammil H. Syed ◽

Mark Wheatcroft ◽

Danny Marcuzzi ◽

Hooman Hennessey ◽

Mohammad Qadura

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Stent Graft ◽

Mycotic Aneurysm ◽

Neurological Deficits ◽

Endovascular Stent ◽

Endovascular Stents ◽

Abdominal Aortic ◽

Short Period

The aim of this paper is to share our experience in managing a patient with Klebsiella pneumoniae mycotic abdominal aortic aneurysm who was also infected with COVID-19. A 69-year-old male was transferred to our hospital for the management of an infra-renal mycotic abdominal aortic aneurysm. During his hospital course, the patient contracted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He was intubated due to respiratory distress. Over a short period, his mycotic aneurysm increased in size from 2.5 cm to 3.9 cm. An emergency repair of his expanding aneurysm was achieved using our previously described protocol of coating endovascular stents with rifampin. The patient was managed with a rifampin-coated endovascular stent graft without any major complications. Postoperatively, the patient did not demonstrate any neurological deficits nor any vascular compromise. He remained afebrile during his postoperative course and was extubated sometime thereafter. He was then transferred to the ward for additional monitoring prior to his discharge to a rehab hospital while being on long-term antibiotics. During his hospital stay, he was monitored with serial ultrasounds to ensure the absence of abscess formation, aortic aneurysm growth or graft endoleak. At 6 weeks after stent graft placement, he underwent a CT scan, which showed a patent stent graft, with a residual sac size of 2.5 cm without any evidence of abscess or endoleak. Over a follow-up period of 180 days, the patient remained asymptomatic while remaining on long-term antibiotics. Thus, in patients whose surgical risk is prohibitive, endovascular stent grafts can be used as a bridge to definitive surgical management.

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