Jill K. Johnstone

Endovascular Repair of Mycotic Aneurysm of the Descending Thoracic Aorta

BACKGROUND Mycotic thoracic aortic aneurysms (MTAAs) are a rare yet life-threatening disease. The current standard of care consists of surgical resection, in situ or extra-anatomic revascularization, and antibiotic therapy. Despite this treatment, mortality remains high (range, 5-40%). The endovascular repair of degenerative thoracic aortic aneurysms has been shown to be safe and effective, but its use in the treatment of MTAAs is still controversial. The purpose of this study is to review the use of endovascular repair for MTAAs. METHODS A 10-year retrospective chart review was conducted of patients who underwent endovascular repair of MTAAs between March 2001 and March 2011. The surgical results of this single-institution review are reported. RESULTS Seven patients underwent endovascular repair of MTAAs. One patient died 2 days postoperatively, which gave an in-hospital survival rate of 85.7%. The 1-year survival rate was 71.4%. The mean follow-up time was 25 months (range, 0-72 months), with a survival rate at that time of 57.1%. All patients were free of infection during their follow-up period. CONCLUSIONS In this single-center case series, endovascular repair of MTAAs was associated with favorable perioperative and short-term mortality and morbidity.

IP235. Transfusion Timing and Postoperative Myocardial Infarction and Death in Patients Undergoing Common Vascular Procedures

Results: In this study, 33 patients (16 diabetic, 17 nondiabetic) who underwent femoral endarterectomy for high-grade occlusive disease were evaluated. No significant difference in key demographics was observed. Tissue plaque FAS content was 69.8% higher in diabetic compared with nondiabetic patients (P 1⁄4 .011); cFAS was also elevated by 41.7% in diabetic patients compared with nondiabetic patients (P 1⁄4 .048). Correlation analysis of 23 patients’ paired samples revealed a significant correlation between cFAS and plaque FAS content (Spearman r 1⁄4 0.4711; r 1⁄4 0.229; P 1⁄4 .023). Conclusions: Our study is the first to evaluate cFAS levels in patients with high-grade, symptomatic, lower extremity peripheral artery disease and demonstrates evidence that cFAS and tissue FAS levels correlate in patients withdiabetes. Future studieswill helpdeterminewhether cFAS is a relevant biomarker for disease severity and progression in diabetic patients.

Escherichia coli primary aortitis presenting as sequelae of incompletely treated urinary tract infection

We report a rare case of nonaneurysmal infectious aortitis (IA) with the causative microorganism being Escherichia coli. The patient was a 78-year-old man who presented with a 3-week history of abdominal pain, fevers, and anorexia after treatment for a urinary tract infection. The patient had positive blood cultures and a computed tomography scan that had signs of IA. He was treated with intravenous antibiotics and extra-anatomic revascularization with excision and debridement of the infected aortic segment with a good outcome. IA is an uncommon condition with a high mortality rate; however, if diagnosed early, it can be successfully treated.