A Case of Placement of the Reversed Gore Exclucder Contralateral Leg for Isolated Left Iliac Mycotic Artery Aneurysm

Koichiro Shimoishi＊	Yoshihiro Fukumoto＊	Kenichi Arata＊
Tomoyuki Matsuba＊	Yuki Ogata＊	Akira Hiwatashi＊
Goichi Yotsumoto＊

(Department of Cardiovascular Surgery, Kagoshima-City Hospital＊, Kagoshima, Japan)

A 49-year-old female with ruptured left common iliac mycotic arterial aneurysm （Lt. CIAA） was brought to our hospital as an emergency case. In Japan, endovascular treatment is unsuitable for the treatment of mycotic aneurysms, but findings from a Swedish national database showed that there was no difference in the long-term prognosis lasting over 10 years. Therefore, we performed endovascular aortic repair （EVAR） and saved the patient’s life. The diameter of the proxymal sealing zone was larger than that of the distal zone. We used the Gore Excluder leg, which was inverted and implanted to match the caliber. Percutaneous abscess drainage was also performed on postoperative day 7 when hemostasis was confirmed for early infection control. The patient was discharged at 8 weeks postoperatively. After discharge from the hospital, oral antibiotics were continued until 6 months after the surgery. Six months postoperatively, contrast-enhanced computed tomography showed that the abscesses have disappeared. Blood samples that were taken at one month after the completion of antibiotics showed no evidence of the recurrence of infection and a curative course was achieved.

 

Jpn. J. Cardiovasc. Surg. 51 : 172-177 （2022）

Keywords：mycotic aneurysm ; stent graft ; prosthetic vascular graft