Endovascular repair for Brucell-infected abdominal aortic aneurysm: one case report and literature review
Received:December 02, 2016  Revised:December 28, 2016
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Key words:aneurysm, infected  abdominal aneurysm  endovascular therapy  Brucella
Author NameAffiliationE-mail
LIU Duan, LIU Xiu, LIU Bao*, SONG Xiao-Jun, ZHENG Yue-Hong Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China liubao72@aliyun.com 
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      Infected aortic aneurysm (IAA) are very rare, and those caused by Brucella are extremely rare. The conventional treatment for IAA is wide debridement of necrotic tissue, establishment of vascular bypass, and perioperative antibiotic treatment. But in recent years, much evidence showed that endovascular treatments were gradually applied as alternatives to open surgery, and the treatments have good outcomes. To summarize our treatment experience of endovascular repair for infected abdominal aorta aneurysm, we reported a case of a 76-year-old male patient and reviewed the articles concerning this disease. The patient had no primitive infectious source (area), and mainly presented fever, abdominal pulsatile mass and waist and abdomen pain. Preoperative peripheral blood culture suggested Brucella infection, and doxycycline treatment was effective. CT angiography displayed a pseudoaneurysm of the distal abdominal aorta. After admission, he underwent endovascular repair treatment followed by sensitive antibiotic therapy, and then was followed up regularly. We also reviewed other cases in the previously published data to summarize the experience on endovascular treatment for Brucella-related abdominal aortic aneurysm, that is, endovascular repair of coated stent graft combined with antibiotic therapy. The patient was followed up for 4 months, and he has normal vital signs at the end of follow-up. On the condition of strict preoperative blood pressure and infection control, and postoperative long-term antibiotic therapy, endovascular treatment is a feasible approach to treat Brucella-caused IAA.