ABSTRACT
Giant cell arteritis, Takayasu arteritis, and Horton disease are rare, idiopathic diseases that cause chronic inflammation and obliteration of large arteries, mainly the aorta and its major branches. Histological examination reveals multinucleated giants cells and clinical presentation is characterized by general symptoms and/or symptoms related to stenosis or occlusion of vessels. A case of a 50-year-old woman with neurological symptoms, cervicothoracic tumour with severe stenosis of the right subclavian artery and complete occlusion of common carotid artery is presented.
Subject(s)
Brachiocephalic Trunk/pathology , Dysarthria/etiology , Giant Cell Arteritis/diagnosis , Mediastinal Neoplasms/etiology , Vascular Neoplasms/etiology , Blood Vessel Prosthesis Implantation , Brachiocephalic Trunk/surgery , Carotid Stenosis/etiology , Dysarthria/surgery , Female , Giant Cell Arteritis/complications , Giant Cell Arteritis/surgery , Humans , Mediastinal Neoplasms/pathology , Mediastinal Neoplasms/surgery , Middle Aged , Sternotomy , Subclavian Steal Syndrome/etiology , Tomography, X-Ray Computed , Treatment Outcome , Vascular Neoplasms/pathology , Vascular Neoplasms/surgeryABSTRACT
BACKGROUND: Aortic stent-graft infections (ASGIs) are associated with significant mortality. We report our experience of two cases of ASGI treated differently and successfully. METHODS: Two patients presented with constitutional symptoms some months after scheduled endovascular repair of aortic aneurysm (EVAR). Patient 1 had an abscess formation around the endograft in continuity with the right groin. Due to patient comorbidities, a conservative treatment was performed. Patient 2 had an abscess formation with air surrounding the stent graft. The patient was treated successfully by endograft removal. RESULTS: Computed tomographic scan follow-up at 6 months from surgery showed no evidence of recurrent infection. CONCLUSION: Despite the recommended treatment of ASGI being surgery, conservative treatment can be performed successfully in patients with high surgical risk, avoiding aortic clamping. We present the first reported case of ASGI due to Streptococcus haemolyticus, the second case due to a fungus, and the second reported case of spondylodiscitis after EVAR.
Subject(s)
Abdominal Abscess/therapy , Anti-Bacterial Agents/therapeutic use , Aortic Aneurysm/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis/adverse effects , Debridement , Device Removal , Prosthesis-Related Infections/therapy , Stents/adverse effects , Abdominal Abscess/diagnostic imaging , Abdominal Abscess/microbiology , Aged , Aortography/methods , Blood Vessel Prosthesis Implantation/instrumentation , Candida albicans/isolation & purification , Discitis/etiology , Enterobacter cloacae/isolation & purification , Humans , Male , Propionibacterium/isolation & purification , Prosthesis-Related Infections/diagnostic imaging , Prosthesis-Related Infections/microbiology , Streptococcus/isolation & purification , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Massive and/or recurrent hemoptysis is a clear indication for surgical treatment of pleuropulmonary aspergilloma, despite the incidence of postoperative morbidity and mortality. Thoracoplasty has been widely used for 20 years and is still indicated in these cases, following lobectomy, even though the procedure is not free of complications. We report the case of a patient who required thoracoplasty to treat a pleuropulmonary aspergilloma invading the chest wall. Subsequent placement of an aortic stent-graft was required due to tearing of the left subclavian artery.
Subject(s)
Angioscopy , Aspergillosis/complications , Aspergillosis/surgery , Aspergillus fumigatus , Bronchial Fistula/microbiology , Bronchial Fistula/surgery , Empyema, Pleural/microbiology , Empyema, Pleural/surgery , Intraoperative Complications/surgery , Lung Diseases, Fungal/complications , Lung Diseases, Fungal/surgery , Respiratory Tract Fistula/microbiology , Respiratory Tract Fistula/surgery , Subclavian Artery/injuries , Thoracoplasty , Humans , Male , Middle AgedABSTRACT
La hemoptisis masiva y/o repetitiva es una indicación clara de tratamiento quirúrgico del aspergiloma pleuropulmonar, a pesar de la morbimortalidad posquirúrgica existente. La toracoplastia, muy utilizada hace 2 décadas, todavía tiene su indicación aquí, tras lobectomía, aunque no está exenta de complicaciones. Presentamos un caso de aspergiloma pleuropulmonar con invasión de pared torácica que requirió toracoplastia y posteriormente técnicas endovasculares aórticas por desgarro de la arteria subclavia izquierda
Massive and/or recurrent hemoptysis is a clear indication for surgical treatment of pleuropulmonary aspergilloma, despite the incidence of postoperative morbidity and mortality. Thoracoplasty has been widely used for 20 years and is still indicated in these cases, following lobectomy, even though the procedure is not free of complications. We report the case of a patient who required thoracoplasty to treat a pleuropulmonary aspergilloma invading the chest wall. Subsequent placement of an aortic stent-graft was required due to tearing of the left subclavian artery
