[Endovascular Repair of Infected Thoracic Aortic Aneurysm whose Shape Changed during Treatment of Infection]

We report a successful case of infected thoracic aortic aneurysm treated by endovascular repair. An 82-year-old woman, presenting with intermittent back pain and low-grade fever, was transferred with the diagnosis of infected thoracic aortic aneurysm. High inflammatory reaction and a thickened aortic wall around the aneurysm confirmed the diagnosis. We performed infection control first because enhanced computed tomography (CT) scanning revealed aneurysm was a low-density mass, which denied aortic pseudoaneurysm or rupture. After administration of broad-spectrum antibiotics, low-grade fever was relieved and inflammatory reactions were decreased. CT performed on the 11th hospital day showed the low-density mass was decreased in size. However, CT performed on the 35th hospital day revealed penetrating atherosclerotic ulcer( PAU) into the low-density mass, which was consistent with saccular aortic aneurysm. The patient underwent thoracic endovascular aortic repair( TEVAR). Postoperative course was uneventful and she was discharged on 22nd postoperative day. Oral administration of antibiotics was continued for 6 months after discharge. Eight months after TEVAR, CT revealed disappearance of the aneurysm. The patient showed no recurrence of infection at 5 years of follow-up.