J Korean Soc Radiol.  2014 May;70(5):331-334. 10.3348/jksr.2014.70.5.331.

Endovascular Stent Graft Repair of Multiple Tuberculous Thoracoabdominal Aneurysms

• Kim SJ
• Won JH

• KMID: 1941776
• DOI: http://doi.org/10.3348/jksr.2014.70.5.331

Abstract

We describe a case of multiple tuberculous aneurysms of the descending thoracic aorta and abdominal aorta repaired with endovascular stent graft. The case was a 47-year-old man who presented with three saccular pseudoaneurysms of aortoiliac bifurcation at computed tomography (CT) scan. Despite of antimycobacterial treatment, these aneurysms grew rapidly and saccular pseudoaneurysm of the descending thoracic aorta was newly seen. A bifurcated stent graft was successfully implanted in the aortoiliac bifurcation. Subsequently, endovascular stent graft was placed well in the descending thoracic aorta. Fourteen months after the procedure, the patient was stable and serial CT images showed regression of aneurysms with ongoing antimycobacterial treatment. Therefore, endovascular stent graft repair with antimycobacterial therapy may be a treatment option in patients with multiple tuberculous aneurysms.

MeSH Terms

Aneurysm*
Aneurysm, False
Aneurysm, Infected
Aorta, Abdominal
Aorta, Thoracic
Blood Vessel Prosthesis*
Humans
Middle Aged

Figure

• 

  Fig. 1 A 47-year-old man with multiple tuberculous aneurysms of the descending thoracic aorta and abdominal aorta. A, B. Pre-procedural computed tomography images demonstrated three saccular pseudoaneurysms of the aortoiliac bifurcation (arrows, A) and one saccular pseudoaneurysm of the descending thoracic aorta (arrow, B). C. Completion angiography after stent graft insertion in the aortoiliac bifurcation showed that the stent graft was well placed and pseudoaneurysms of the aortoiliac bifurcation were completely excluded.

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  Fig. 2 Treatment of endoleak and pseudoaneurysm of thoracic aorta. A. One month after the procedure, type II endoleak was persistently seen. Direct puncture of the endoleak sac was performed via transabdominal approach. Angiography through the endoleak sac demonstrated the endoleak sac communicating with the left fourth lumbar artery. B. After stent graft insertion in the descending thoracic aorta, completion angiography demonstrated that the stent graft was placed correctly in the descending thoracic aorta.

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  Fig. 3 Fourteen months after the procedure, a volume rendering CT image demonstrated that the endovascular stents of the aortoiliac bifurcation and descending thoracic aorta were placed well without recurrence.

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