Endovascular Repair of Ruptured Infected Arteries as a Temporizing Measure Versus Destination Therapy

Vasc Endovascular Surg. 2016 Aug;50(6):373-9. doi: 10.1177/1538574416655894. Epub 2016 Jul 15.

Abstract

Objective: Mycotic rupture of the arteries is a rare but deadly disorder. Current management typically involves open surgical repair. However, endovascular repair is a potential treatment that can be used to delay open repair, especially in acutely unstable patients. A case report and review of the literature was conducted to determine whether endovascular therapy could be a destination therapy for patients with arterial rupture secondary to infection.

Methods: We present the case of a 72-year-old man with a left common iliac artery aneurysm rupture secondary to Salmonella infection treated with endovascular therapy upon initial presentation. A literature review of PubMed yielded 29 patients with ruptured aortic and iliac infected aneurysms that were initially treated with endovascular repair.

Results: Majority of the patients (76.7%, 23 of 30) were successfully treated with the endovascular treatment and did not require open revision. These patients were often placed on long-term antibiotics.

Conclusion: The literature review supports endovascular repair with a stent graft as a temporizing measure for infected ruptured arteries in an emergent setting and, in select cases, as a destination therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Infected / diagnostic imaging
  • Aneurysm, Infected / microbiology
  • Aneurysm, Infected / surgery*
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / microbiology
  • Aneurysm, Ruptured / surgery*
  • Anti-Bacterial Agents / therapeutic use
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Computed Tomography Angiography
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Humans
  • Iliac Aneurysm / diagnostic imaging
  • Iliac Aneurysm / microbiology
  • Iliac Aneurysm / surgery*
  • Male
  • Postoperative Complications / etiology
  • Risk Factors
  • Salmonella Infections / diagnosis
  • Salmonella Infections / microbiology
  • Salmonella Infections / surgery*
  • Stents
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents