Repair of a complex thoracic aneurysm from relapsing polychondritis
Chad E Jacobs1, Robert J March, Peter J Hunt
1Division of Vascular Surgery, Rush University Medical Center, Chicago, IL 60612, USA. chad_jacobs@rush.edu
Vascular and Endovascular Surgery
|May 10, 2013
Summary
Relapsing polychondritis (RP) can cause aortic aneurysms. This case highlights successful endovascular repair in an RP patient with thoracic aortic aneurysmal dilatation, a rare but serious complication.
Area of Science:
- Cardiovascular Surgery
- Rheumatology
- Vascular Medicine
Background:
- Relapsing polychondritis (RP) is a rare autoimmune disease affecting cartilage.
- Aneurysmal disease occurs in 4-7% of RP patients, necessitating awareness among vascular surgeons.
- Thoracic aortic aneurysms present a significant challenge in RP management.
Observation:
- A 29-year-old female with a history of RP and prior thoracic aneurysm repair presented with asymptomatic aortic dilatation.
- The patient developed symptomatic aneurysm expansion within 3 months, requiring surgical intervention.
- Ascending aortic arch replacement was performed, followed by staged endovascular repair of the distal descending thoracic aorta.
Findings:
- This case details the first reported use of endovascular techniques for thoracic aortic aneurysms in a patient with relapsing polychondritis.
- The successful staged endovascular repair demonstrates a viable treatment option for complex aortic pathology in RP.
- The patient's presentation underscores the importance of vigilant monitoring for aneurysmal disease in RP.
Implications:
- Vascular surgeons should consider RP in the differential diagnosis for aortic aneurysms, especially in younger patients.
- Endovascular repair may offer a less invasive approach for managing aortic complications in select RP patients.
- Further research into the optimal management strategies for aortic disease in relapsing polychondritis is warranted.
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