Mycotic aneurysm of the common iliac artery and distal aorta following stent placement

Kenneth E. McIntyre, Eric Walser, Joseph Hagman, Diann Schaper

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

A 43-year-old man was evaluated for disabling left leg claudication. Aortography demonstrated occlusion of the left common and external iliac arteries with reconstitution of the left common femoral artery. During this procedure a 10 mm x 9.4 cm Wallstent was placed from the proximal common iliac to the mid-external iliac artery followed by a 10 mm Palmaz stent placed proximal to the Wallstent. He returned after 2 weeks with recurrent symptoms and an absent left femoral pulse. Repeat aortography confirmed that the stented iliac artery was thrombosed. Following thrombolysis, a stenosis distal to the Wallstent was identified and another 8 mm x 4 cm Wallstent was inserted to dilate the stenotic lesion. He did well until the following week when he returned complaining of fever, anorexia, and low back pain. Staphylococcus aureus was cultured from the blood. An initial computed tomography (CT) scan demonstrated only inflammation around the distal aorta, but owing to unremitting fever and symptoms, he underwent another CT scan 4 days later, which demonstrated a large aneurysm of the distal aorta and left common iliac artery. The patient was taken to the operating room where a right-to-left femorofemoral bypass was performed. After the groin wounds were closed, an exploratory laparotomy disclosed a large mycotic aneurysm of the distal aorta and proximal left common iliac artery. The aorta was oversewn below the level of the inferior mesenteric artery (IMA) and the Palmaz and proximal Wallstent were removed. An IMA thrombectomy was performed because no Doppler flow was present in the sigmoid mesentery. Following abdominal closure, a right axillofemoral graft and thrombectomy of the femorofemoral graft were performed. On postoperative day 12, he developed an ileus and signs of sepsis. Upon reexploration, a sigmoid perforation was discovered and a sigmoid resection and colostomy were performed. He was treated with parenteral antibiotics and enteral nutrition and was transferred for continued rehabilitation 8 weeks later.

Original languageEnglish (US)
Pages (from-to)551-557
Number of pages7
JournalVascular Surgery
Volume31
Issue number5
StatePublished - 1997

Fingerprint

Infected Aneurysm
Iliac Artery
Stents
Aorta
Sigmoid Colon
Inferior Mesenteric Artery
Aortography
Thrombectomy
Fever
Tomography
Transplants
Mesentery
Colostomy
Ileus
Groin
Parenteral Nutrition
Anorexia
Enteral Nutrition
Femoral Artery
Operating Rooms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Mycotic aneurysm of the common iliac artery and distal aorta following stent placement. / McIntyre, Kenneth E.; Walser, Eric; Hagman, Joseph; Schaper, Diann.

In: Vascular Surgery, Vol. 31, No. 5, 1997, p. 551-557.

Research output: Contribution to journalArticle

McIntyre, KE, Walser, E, Hagman, J & Schaper, D 1997, 'Mycotic aneurysm of the common iliac artery and distal aorta following stent placement', Vascular Surgery, vol. 31, no. 5, pp. 551-557.
McIntyre, Kenneth E. ; Walser, Eric ; Hagman, Joseph ; Schaper, Diann. / Mycotic aneurysm of the common iliac artery and distal aorta following stent placement. In: Vascular Surgery. 1997 ; Vol. 31, No. 5. pp. 551-557.
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