Endovascular Stent Graft Repair of Multiple Tuberculous Thoracoabdominal Aneurysms

Abstract

We describe a case of multiple tuberculous aneurysms of the descending thoracic aorta and abdominal aorta repaired with endovascular stent graft. The case was a 47-year-old man who presented with three saccular pseudoaneurysms of aortoiliac bifurcation at computed tomography (CT) scan. Despite of antimycobacterial treatment, these aneurysms grew rapidly and saccular pseudoaneurysm of the descending thoracic aorta was newly seen. A bifurcated stent graft was successfully implanted in the aortoiliac bifurcation. Subsequently, endovascular stent graft was placed well in the descending thoracic aorta. Fourteen months after the procedure, the patient was stable and serial CT images showed regression of aneurysms with ongoing antimycobacterial treatment. Therefore, endovascular stent graft repair with antimycobacterial therapy may be a treatment option in patients with multiple tuberculous aneurysms.

47세 남자 환자가 치료에도 호전을 보이지 않는 엉덩이 부위의 농양과 결핵성 림프절염으로 내원하였다. 시행한 전산화단층촬영에서 우연히 복부대동맥 분지부에 3개의 가성동맥류가 발견되었고 항결핵제 치료에도 불구하고 이들 동맥류의 크기가 증가하였으며 새로이 흉부대동맥에도 동맥류가 발생하였다. 따라서 흉부대동맥과 복부대동맥에 스텐트 그라프트를 삽입하였고 동맥류는 결찰되었다. 시술 후 항결핵제 치료를 지속하였으며 이후 14개월 동안 재발 또는 증상을 보이지 않았다.