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Ann Thorac Surg 2002;74:2184-2186
© 2002 The Society of Thoracic Surgeons

Case report

Endovascular management of a ruptured mycotic aneurysm of the innominate artery

Ruth L. Bush, MD*a, Julian E. Hurt, MDa, Charles C. Bianco, MDa

a Cardiac and Vascular Surgery Center, Tallahassee Memorial Hospital, Tallahassee, Florida, USA

Accepted for publication July 1, 2002.

* Address reprint requests to Dr Bush, Cardiac and Vascular Surgery Center, 1405 Centerville Road, Suite 5000, Tallahassee, FL 32308, USA.
e-mail: rlbush{at}aol.com

Mycotic aneurysms of the innominate artery are infrequent lesions and, as such, represent challenging surgical problems. We describe herein a case of a ruptured mycotic innominate artery aneurysm, which developed after radical neck dissection and radiation therapy for tonsillar carcinoma. The aneurysm was successfully excluded from the systemic circulation with endoluminal placement of a covered stent, with efficacy confirmed by vascular imaging at 6 months follow-up. The patient suffered no permanent neurologic sequelae. Long-term follow-up and chronic antibiotic therapy will be necessary to avoid infection of the covered stent in this high-risk surgical patient.




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