Case Of Aortic Aneurysm Research Articles

Three Cases of Thoracic Aortic Aneurysm with Aberrant Right Subclavian Artery

Three Cases of Thoracic Aortic Aneurysm with Aberrant Right Subclavian Artery

Assessment of fenestrated Anaconda stent graft design by numerical simulation: Results of a European prospective multicenter study.

A crucial step in designing fenestrated stent grafts for treatment of complex aortic abdominal aneurysms is the accurate positioning of the fenestrations. The deployment of a fenestrated stent graft prototype in a patient-specific rigid aortic model can be used for design verification invitro, but is time and human resources consuming. Numerical simulation (NS) of fenestrated stent graft deployment using the finite element analysis has recently been developed; the aim of this study was to compare the accuracy of fenestration positioning by NS and invitro. All consecutive cases of complex aortic abdominal aneurysm treated with the Fenestrated Anaconda (Terumo Aortic) in six European centers were included in a prospective, observational study. To compare fenestration positioning, the distance from the center of the fenestration to the proximal end of the stent graft (L) and the angular distance from the 0° position (C) were measured and compared between invitro testing (L1, C1) and NS (L2, C2). The primary hypothesis was that ΔL (|L2 - L1|) and ΔC (|C2 - C1|) would be 2.5 or less mm in more than 80% of the cases. The duration of both processes was also compared. Between May 2018 and January 2019, 50 patients with complex aortic abdominal aneurysms received a fenestrated stent graft with a total of 176 fenestrations. The ΔL and ΔC was 2.5mm or less for 173 (98%) and 174 (99%) fenestrations, respectively. The NS process duration was significantly shorter than the invitro (2.1days [range, 1.0-5.2days] vs 20.6days [range, 9-82days]; P< .001). Positioning of fenestrations using NS is as accurate as invitro and could significantly decrease delivery time of fenestrated stent grafts.

Multidisciplinary Team Decisions in Management of Abdominal Aortic Aneurysm: A Service and Quality Evaluation

ObjectiveTo investigate whether decisions made by the multidisciplinary team (MDT) were implemented and review the MDT process to identify areas for improvement.MethodsThis was a retrospective service evaluation project. Consecutive cases of abdominal aortic aneurysm (AAA) from vascular surgery MDT meetings were reviewed. MDT outputs were extracted and compared with implemented clinical management obtained from the electronic health record (EHR) to determine concordance. Cases were re-reviewed to understand reasons why planned management was not implemented.ResultsFrom 42 MDT meetings, 106 patients were identified. Twenty four patients were discussed at two MDTs and four patients were discussed three times. Of the 106 patients, 91 (85.8%) were treated as planned, seven (6.6%) declined planned management and opted for conservative management, four (3.8%) patients died before treatment, and four (3.8%) had alternative management for individual reasons. Of the patients discussed multiple times, 15 (53.6%) needed review by a consultant anaesthetist or additional investigations.ConclusionThis service evaluation found a similar proportion of cases as in existing oncology literature where the MDT decision was not implemented. However, the natural history of AAA brings nuance to this finding. Facilitating patient preference is an important problem that will require future study. This evaluation resulted in local improvements to the MDT process for AAA.

Aortic Valve and Arch Replacements in a High-Risk Patient with Essential Thrombocythemia

Reports of the clinical results of cardiac surgery in patients with Essential Thrombocythemia (ET) are rare. In addition, cases of aortic arch aneurysm in ET have not been previously reported. We present a successful aortic valve and arch replacements with the frozen elephant trunk technique using hypothermic circulatory arrest in an ET patient with grade 3 aortic regurgitation and arch aneurysms. Reducing platelet count via the administration of anagrelide and the careful balancing of antiplatelets and anticoagulants is essential in determining the outcome of surgery.

Tubercular Mycotic Aortic Aneurysm: Complication of Tubercular Spondylodiscitis due to Treatment Default

AbstractWe have reported rare case of tubercular aortic aneurysm which has developed as complication of spinal tuberculosis. Imaging of patient is available prior to starting of antitubercular treatment which showed vertebral tuberculosis with absence of aortic aneurysm. However, patient defaulted on treatment after taking antitubercular chemotherapy only for 2 months. Patient again reported after 14 months with chest pain. At this stage, imaging showed progression of spinal tuberculosis with development of pseudoaneurysm in adjacent descending thoracic aorta. This contiguous spread of tuberculosis from spine to aorta may have been prevented if patient had completed complete course of antitubercular therapy with regular follow-ups. Patient of spinal tuberculosis need to be counselled and informed regarding its various complications, so that they remain adhered to antitubercular chemotherapy and timely follow-ups to prevent complications.

Vascular Surgery in Japan: 2016 Annual Report by the Japanese Society for Vascular Surgery.

Objectives: This is an annual report indicating the number and early clinical results of annual vascular treatment performed by vascular surgeon in Japan in 2016, as analyzed by database management committee (DBC) members of the JSVS.Materials and Methods: To survey the current status of vascular treatments performed by vascular surgeons in Japan, the DBC members of the JSVS analyzed the vascular treatment data provided by the National Clinical Database (NCD), including the number of treatments and early results such as operative and hospital mortality.Results: In total 136,414 vascular treatments were registered by 1,070 institutions in 2016. This database is composed of 7 fields including treatment of aneurysms, chronic arterial occlusive disease, acute arterial occlusive disease, vascular injury, complication of previous vascular reconstruction, venous diseases, and other vascular treatments. The number of vascular treatments in each field was 21,653, 17,560, 4,983, 2,557, 846, 54,462 and 34,353, respectively. In the field of aneurysm treatment, 19,144 cases of abdominal aortic aneurysm (AAA) including common iliac aneurysm were registered, and 60.3% were treated by endovascular aneurysm repair (EVAR). Among AAA cases, 1,714 (9.4%) cases were registered as ruptured AAA. The operative mortality of ruptured and unruptured AAA was 15.7%, and 0.6%, respectively. 35.9% of ruptured AAA were treated by EVAR, and the EVAR ratio was gradually increasing, but the operative mortality of open repair and EVAR for ruptured AAA was 15.8%, and 15.3%, respectively. Regarding chronic arterial occlusive disease, open repair was performed in 9,303 cases, including 1,329 distal bypasses to the crural or pedal artery, whereas endovascular treatment (EVT) was performed in 8,257 cases. The EVT ratio was gradually increased at 47.0%. The number of varicose vein treatment tremendously increased to 52,639, and 68.5% of the cases were treated by endovenous laser ablations (EVLA). Regarding other vascular operations, 32,779 cases of vascular access operations and 1,411 lower limb amputation surgeries were included.Conclusions: The number of vascular treatments increased since 2011, and the proportion of endovascular procedures increased in almost all field of vascular diseases, especially EVAR for AAA, EVT for chronic arterial occlusive disease, and EVLA for varicose veins. (This is a translation of Jpn J Vasc Surg 2021; 30: 23–41.)

Thermal elevation on midriff skin surface as a potential diagnostic feature for Abdominal Aortic Aneurysm using Infrared Thermography (IRT)

In this study, coupled Computational Fluid Dynamics (CFD) and Computational Heat Transfer (CHT) unsteady simulation was employed to study pulsatile blood flow through the infrarenal aorta and the subsequent bioheat transfer effects on the temperature profile on the midriff skin surface. It was observed that a thermal elevated feature was present on the midriff abdomen surface for the Abdominal Aortic Aneurysm (AAA) case while the temperature contours for the healthy aorta model were uniform. The temperature values of the thermal elevation differ from its immediate surroundings by 0.04K. An experiment was also conducted to validate the CFD simulation results, and it showed similar thermal elevation trend at the surface of the phantom. These findings are helpful to correlate the presence of an AAA to the thermal features on the midriff skin surface qualitatively and pave the way to potentially render Infrared Thermography a viable AAA diagnostic tool.

Abdominal aorta measurements by a handheld ultrasound device compared with a conventional cart-based ultrasound machine.

BACKGROUND: Ultraportable or pocket handheld ultrasound devices (HUD) may be useful for large-scale abdominal aortic aneurysm screening. However, the reproducibility of measurements has not been compared with conventional cart-based ultrasound machines.OBJECTIVES: Investigate the intra- and inter-operator reproducibility of a HUD compared with a conventional ultrasound machine for aortic screening.DESIGN: Analytical, cross-sectional.SETTING: Ultrasound department at a large tertiary care hospital in Riyadh.PATIENTS AND METHODS: Eligible male participants aged ≥60 years were invited to participate upon arriving for a non-vascular ultrasound appointment. Three repeated anteroposterior measurements of the transverse aorta were made at the proximal and distal locations for each machine before repeating the measurements on a subset of participants by a second blinded operator. Intraclass correlation coefficients (ICC) and the Bland-Altman method were used to analyze reproducibility.MAIN OUTCOME MEASURE: Inter-system and intra- and inter-operator ICCs.SAMPLE SIZE: 114 males with repeated measurements by second operator on a subset of 35 participants.RESULTS: The median age (interquartile range) of participants was 68 years (62–74 years). The intra- and inter-operator ICCs were all >0.800 showing almost perfect agreement except for the inter-operator reproducibility at the proximal location using a conventional machine (ICC= 0.583, P=.007) and the Butterfly device (ICC=0.467, P=.037). The inter-system ICCs (95% CI) were 0.818 (0.736–0.874) and 0.879 (0.799–0.924) at the proximal and distal locations, respectively. The mean difference in aortic measurement between the ultrasound systems was 0.3 mm (1.7%) in the proximal location and 0.6 mm (3.6%) in the distal location. In total, >91% of the difference in measurements between the machines was <3 mm. The mean scanning time was 4:16 minutes for the conventional system and 3:53 minutes for the HUD (P=.34).CONCLUSIONS: Abdominal aortic screening using a HUD was feasible and reliable compared with a conventional ultrasound machine. A pocket HUD should be considered for large-scale screening.LIMITATIONS: No cases of abdominal aortic aneurysm in the sample and lack of blinding.CONFLICT OF INTEREST: None.

Sex Differences in Proximal Thoracic Aortic Disease Pathology: A Call to Action

Abstract Introduction/Objective Sex disparity is reported across all forms of cardiovascular diseases. Only few studies have focused on sex differences in thoracic aortic disease pathology. We aim to identify and understand sex differences in this patient group to bridge the knowledge gap and improve clinicopathologic outcomes. Methods/Case Report This is a retrospective analysis of 83 proximal thoracic aortic aneurysm and dissection (TAAD) cases treated at a single quaternary care center in 2019. Chart review was done for demographics. Consensus criteria (Stone JR et al. Cardiovasc Pathol 2015; 24:267-78; Halushka MK et al. Cardiovasc Pathol 2016; 25:247-57) and a scoring system (Waters KM et al. Cardiovasc Pathol 2017; 30:6-11) were used for pathology reporting. Clinical correlation was also made. Pearson’s chi-square test was used for statistical analysis. Results (if a Case Study enter NA) 83 patients (61 male and 22 female) were retrieved. Overall thoracic aortopathy was higher among males, accounting for 73.4% of individuals with TAAD. In a subgroup analysis, there was no sex difference in dissection, aortic root involvement, and bicuspid aortic valve (p&amp;gt;0.05). Genetic aortopathy was more prevalent in females than males (27.2% vs 9.8%, p=0.04) alongside early age at first aortic event (median age: 31y vs 52y). Histopathologically, females had frequent translamellar mucoid extracellular matrix accumulation (45.4% vs 22.9%, p=0.04), extensive (54.5% vs 27.8%, p=0.02) and severe (59% vs 34.4%, p=0.04) elastic fiber fragmentation, higher band like (9% vs 6.5%, p&amp;gt;0.05) plus extensive (13.6% vs 4.9%, p&amp;gt;0.05) smooth muscle nuclei loss, and extensive (13.6% vs 1.6%, p=0.01) plus dense (4.5% vs 1.6%, p&amp;gt;0.05) laminar medial collapse than males. Conclusion In our patient population, females have a lower prevalence of thoracic aortic disease treated with open repair. However, those who develop TAAD harbor a greater burden of wall pathology and probable worse outcomes. We recommend sex-based analysis of all research on thoracic aortic diseases.

922 Pre-Operative Chest X-Ray Prior To Aneurysm Surgery Is Unnecessary

Abstract Aim Over 4100 elective abdominal aortic aneurysm (AAA) cases are performed each year in the UK. In our tertiary centre the anaesthetic pre-operative protocol for these patients includes a chest x-ray (CXR), because some risk factors for aneurysmal disease (smoking, older age) cross over with those for lung cancer. This study was performed to see if the CXR changed management in AAA patients. Method A retrospective radiology review of 191 consecutive patients who had an elective AAA repair at one unit in 2017-2018 was carried out. Computed tomography angiogram (CTA) and CXR findings were compared. Where an abnormality was reported, patient records were reviewed and the impact of the abnormal result on the patient journey assessed. Results Of 191 patients, 148 had pre-op CXRs. Of the CXRs, 60 reported abnormalities, most of which were minor (cardiomegaly, atelectasis, reticular shadowing). Of the 60, 28 had no lung abnormalities on CTA, 18 had not had a reported CTA, 8 corresponded with the CTA and 6 had a different chest abnormality reported on the CTA. 2 patients had CTs of the chest following CXR findings and no patients had an operation cancelled or delayed due to findings on CXR. Conclusions Each CXR costs around £20 including reporting and administration time. In addition, there is inconvenience to the patient and additional radiation dose. None of the pre-operative CXRs resulted in a change to patient operative management therefore the requirement for pre-operative CXR was removed from the units’ protocol.

Vascular Surgery in Japan: 2015 Annual Report by the Japanese Society for Vascular Surgery.

Objectives: This is an annual report indicating the number and early clinical results of annual vascular treatment performed by vascular surgeon in Japan in 2015, as analyzed by database management committee (DBC) members of the JSVS.Materials and Methods: To survey the current status of vascular treatments performed by vascular surgeons in Japan, the DBC members of the JSVS analyzed the vascular treatment data provided by the National Clinical Database (NCD), including the number of treatments and early results such as operative and hospital mortality.Results: In total 124,299 vascular treatments were registered by 1,038 institutions in 2015. This database is composed of 7 fields including treatment of aneurysms, chronic arterial occlusive disease, acute arterial occlusive disease, vascular injury, complication of previous vascular reconstruction, venous diseases, and other vascular treatments. The number of vascular treatments in each field was 22,041, 15,671, 4,779, 2,313, 857, 48,837, and 29,801, respectively. In the field of aneurysm treatment, 18,907 cases of abdominal aortic aneurysm (AAA) including common iliac aneurysm were registered, and 57.6% were treated by endovascular aneurysm repair (EVAR). Among AAA cases, 1,850 (9.8%) cases were registered as ruptured AAA. The operative mortality of ruptured and un-ruptured AAA was 16.0%, and 0.6%, respectively. 33.6% of ruptured AAA were treated by EVAR, and the EVAR ratio was gradually increasing, but the operative mortality of open repair and EVAR for ruptured AAA was 16.6%, and 14.5%, respectively. Regarding chronic arterial occlusive disease, open repair was performed in 8,230 cases, including 1,194 distal bypasses to the crural or pedal artery, whereas endovascular treatment (EVT) was performed in 7,441 cases. The EVT ratio was gradually increased at 47.4%. Venous treatment including 47,046 cases with varicose vein treatments and 531 cases with lower limb deep vein thrombosis were registered. Regarding other vascular operations, 29,801 cases of vascular access operations and 1,511 lower limb amputation surgeries were included.Conclusions: The number of vascular treatments increased since 2011, and the proportion of endovascular procedures increased in almost all field of vascular diseases, especially EVAR for AAA, EVT for chronic arterial occlusive disease, and endovenous laser ablation (EVLA) for varicose veins. (This is a translation of Jpn J Vasc Surg 2020; 29: 161–179.)

A Rare Case of Abdominal Aortic Aneurysm with Ureteral Compression

Abstract Introduction: In this report, we present a rare case of aortic aneurysm with associated left ureter obstruction and consequent hydronephrosis. Case presentation: A 62-year-old man was admitted for epigastric and periumbilical pain, extended in the spine, and anuria. As for associated diseases, he presented arterial hypertension stage II/III, chronic ischemic cardiomyopathy, acidosis, hyperpotassemia, spondylosis with radiculopathy, acute renal failure, renal lithiasis, and eating difficulties. After performing a CT scan, the patient was diagnosed with giant abdominal infrarenal aortic aneurysm with ureter compression, and retroperitoneal rupture with common and internal iliac arteries occlusion. We performed a xifo-pubian laparotomy with endoaneurysmorrhaphy and aortoiliac bilateral bypass using silver Dacron vascular prosthesis (16 × 8 mm in diameter). Douglas drainage was necessary, ending with laparoraphy. The patient presented a favorable postoperative evolution. Conclusion: Open surgery remains the gold standard method of treatment for large aortic aneurysms, given the inability of endovascular procedures to solve problems caused by compression.

Aortic aneurysm in Nigeria

Abstract Background: Aortic aneurysm was previously reported to be uncommon in the black African. However, with lifestyle modifications and continuous improvement and availability of diagnostic facilities and structures in Sub-Saharan African countries, a surge in the incidence of aortic aneurysms is expected. This current study is aimed at exploring the cases of aortic aneurysms and the outcome of their management in Nigeria, the most populous country in Black Africa. Methods: A systematic literature search of all articles on Aortic aneurysm in as well as from Nigeria will be conducted using several electronic databases including PubMed, African Journal Online, Google Scholar, Cochrane Library, MEDLINE and Scopus. The search will span the period from the database inception to June 2021. Only studies retrievable in the English language will be included. The primary outcome will be the mortality rate, while secondary outcomes will include the size of the aneurysm, type of aneurysm, diagnostic imaging findings, and management. The identified studies will be screened and de-duplicated by two independent researchers using Rayyan Qatar Computing Research Institute software, while the third author will be a tiebreaker. Statistical analysis will be performed using STATA version 16. The Grades of Recommendation, Assessment, Development and Evaluation system will be used to evaluate the quality of evidence. Results: The epidemiological dynamics, clinico-radiological pattern and profile, management strategies and outcomes of all documented cases of Aortic aneurysm in Nigeria, will be systemically evaluated. Conclusion: This study will provide indigenous data that will be beneficial to the practice of all cardiovascular specialists- cardiologists, surgeons, radiologist and interventionists; evaluating and managing patients with Aortic aneurysms within Nigeria and other settings with a similar genealogical profile within Africa and other parts of the world. Ethics and Dissemination: Ethical approval not required as study is a review, analysis and synthesis of already published data PROSPERO registration number: CRD42021258646

Computational Fluid Dynamic Analysis Supports the Hemodynamic Stability of Hybrid Combinations With the AFX Bifurcate and Nitinol-Based Proximal Segments in Solutions of Failed Endovascular Aneurysm Repair

Hybrid endograft combinations of two or more different types of covered stents are rarely reported to treat complex abdominal aortic aneurysm cases or primary and secondary endoleaks. Clinical and laboratory data regarding the clinical efficacy and mechanical stability of such combinations are lacking. Based on a recently published case report, we describe and comment on the hemodynamic profile of a representative simulated hybrid case of AFX and Nitinol-based proximal cuff and support the stability of this combination in non-angulated cases.

Cardiomyopathy in Genetic Aortic Diseases.

Genetic aortic diseases are a group of illnesses characterized by aortic aneurysms or dissection in the presence of an underlying genetic defect. They are part of the broader spectrum of heritable thoracic aortic disease, which also includes those cases of aortic aneurysm or dissection with a positive family history but in whom no genetic cause is identified. Aortic disease in these conditions is a major cause of mortality, justifying clinical and scientific emphasis on the aorta. Aortic valve disease and atrioventricular valve abnormalities are known as important additional manifestations that require careful follow-up and management. The archetype of genetic aortic disease is Marfan syndrome, caused by pathogenic variants in the Fibrillin-1 gene. Given the presence of fibrillin-1 microfibers in the myocardium, myocardial dysfunction and associated arrhythmia are conceivable and have been shown to contribute to morbidity and mortality in patients with Marfan syndrome. In this review, we will discuss data on myocardial disease from human studies as well as insights obtained from the study of mouse models of Marfan syndrome. We will elaborate on the various phenotypic presentations in childhood and in adults and on the topic of arrhythmia. We will also briefly discuss the limited data available on other genetic forms of aortic disease.

A computational wall mechanics study of an ascending thoracic aortic aneurysm under hypertensive conditions

A wall mechanics study is performed on two human aortic models, reconstructed from computed tomography (CT) image data using the Materialise Mimics software. The first model represents a rare ascending thoracic aortic aneurysm (aTAA) case with an excessive aortic ballooning that has displaced the cardiac cavities, and the second one a normal case free of cardiovascular diseases. Special attention was paid for the reconstruction of realistic models that do not deviate from the original data. The study presents the workflow from medical imaging data to structural simulation with the use of various software, aiming to examine the stress state of a normal aorta and an aneurysmal one (both patient specific) under a range of systolic blood pressure loads. Using the FEBio software, the effective (Lagrange) strain and the effective stress (von Mises) distributions are calculated for assessing the risk of rupture or dissection of the aorta.

Two operative cases of abdominal aortic aneurysm with isolated dissection of the abdominal aorta.

Objective: Isolated abdominal aortic dissection (IAAD) co-occurring with an abdominal aortic aneurysm (AAA) is rather rare. The objective of this report was to discuss the adequate timing and method of surgery for this condition.Patients: We encountered two operative cases, for which we carefully considered the timing and method of surgery. One patient underwent open repair 1 month after the onset, and the other patient underwent endovascular aneurysm repair (EVAR) 3 years after the onset.Results: Both patients had a good postoperative recovery and are doing well 8 months after the surgery.Conclusion: The presence of symptoms or an increase in the diameter of an AAA is important in determining the timing of intervention.

Comparison of Clinical Effects of Abdominal Aortic Aneurysm Treatment with Open and Endovascular Techniques

Objective: To compare the therapeutic effects of endovascular and open surgery on abdominal aortic aneurysms. Methods: From June 2019 to May 2020, 60 cases of abdominal aortic aneurysms (AAA) were divided into observation group (30 cases in endovascular technique group) and control group (30 cases in open technique group). Results: The blood loss, operative time and blood transfusion of the observation group were significantly lower than those of the control group (P&lt;0.05). The incidence of postoperative complications is low, and the incidence of long-term complications is relatively high. Conclusion: In the treatment of abdominal aortic aneurysm, endovascular technology has the advantages of low risk, less trauma, and quick recovery after surgery. Open surgery is suitable for patients who cannot receive endovascular treatment. In order to achieve good treatment effects, it is necessary to choose an appropriate treatment method according to the actual situation of the patient.

Vascular Surgery in Japan: 2014 Annual Report by the Japanese Society for Vascular Surgery.

Objectives: This is an annual report indicating the number and early clinical results of annual vascular treatment performed by vascular surgeon in Japan in 2014, as analyzed by database management committee (DBC) members of the JSVS.Materials and Methods: To survey the current status of vascular treatments performed by vascular surgeons in Japan, the DBC members of the JSVS analyzed the vascular treatment data provided by the National Clinical Database (NCD), including the number of treatments and early results such as operative and hospital mortality.Results: In total 113,296 vascular treatments were registered by 1,002 institutions in 2014. This database is composed of 7 fields including treatment of aneurysms, chronic arterial occlusive disease, acute arterial occlusive disease, vascular injury, complication of previous vascular reconstruction, venous diseases, and other vascular treatments. The number of vascular treatments in each field was 21,085, 14,344, 4,799, 2,088, 1,598, 42,864, and 26,518, respectively. In the field of aneurysm treatment, 17,973 cases of abdominal aortic aneurysm (AAA) including common iliac aneurysm were registered, and 55.7% were treated by endovascular aneurysm repair (EVAR). Among AAA cases, 1,824 (10.1%) cases were registered as ruptured AAA. The operative mortality of ruptured and un-ruptured AAA was 16.1%, and 0.6%, respectively. 32.1% of ruptured AAA were treated by EVAR, and the EVAR ratio was gradually increasing, but the operative mortality of open repair and EVAR for ruptured AAA was 15.7%, and 18.0%, respectively. Regarding chronic arterial occlusive disease, open repair was performed in 8,020 cases, including 1,210 distal bypasses to the crural or pedal artery, whereas endovascular treatment (EVT) were performed in 6,324 cases. The EVT ratio was gradually increased at 44.1%. Venous treatment including 41,246 cases with varicose vein treatments and 520 cases with lower limb deep vein thrombosis were registered. Regarding other vascular operations, 25,024 cases of vascular access operations and 1,322 lower limb amputation surgeries were included.Conclusions: The number of vascular treatments increased since 2011, and the proportion of endovascular procedures increased in almost all field of vascular diseases, especially EVAR for AAA, EVT for chronic arterial occlusive disease, and endovenous laser ablation (EVLA) for varicose veins. (This is a translation of Jpn J Vasc Surg 2020; 29: 15–31.)

Infected aortic aneurysm caused by Helicobacter cinaedi: case series and systematic review of the literature

BackgroundHelicobacter cinaedi is rarely identified as a cause of infected aneurysms; however, the number of reported cases has been increasing over several decades, especially in Japan. We report three cases of aortic aneurysm infected by H. cinaedi that were successfully treated using meropenem plus surgical stent graft replacement or intravascular stenting. Furthermore, we performed a systematic review of the literature regarding aortic aneurysm infected by H. cinaedi.Case presentationWe present three rare cases of infected aneurysm caused by H. cinaedi in adults. Blood and tissue cultures and 16S rRNA gene sequencing were used for diagnosis. Two patients underwent urgent surgical stent graft replacement, and the other patient underwent intravascular stenting. All three cases were treated successfully with intravenous meropenem for 4 to 6 weeks.ConclusionsThese cases suggest that although aneurysms infected by H. cinaedi are rare, clinicians should be aware of H. cinaedi as a potential causative pathogen, even in immunocompetent patients. Prolonged incubation periods for blood cultures are necessary for the accurate detection of H. cinaedi.