Stent-graft Implantation for Clinically Diagnosed Syphilitic Aortic Aneurysm in an HIV-infected Patient

  • Yasuda Shota
    Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
  • Imoto Kiyotaka
    Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
  • Uchida Keiji
    Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
  • Kawaguchi Satoshi
    Department of Vascular Surgery, Center for Minimally Invasive Treatment of Cardiovascular Disease, Tokyo Medical University, Tokyo, Japan
  • Yokoi Yoshihiko
    Department of Vascular Surgery, Center for Minimally Invasive Treatment of Cardiovascular Disease, Tokyo Medical University, Tokyo, Japan
  • Shigematsu Hiroshi
    Department of Vascular Surgery, Center for Minimally Invasive Treatment of Cardiovascular Disease, Tokyo Medical University, Tokyo, Japan
  • Masuda Munetaka
    Department of Cardiovascular Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan

抄録

We describe our experience with stent-graft placement in a patient with a clinically diagnosed syphilitic aortic aneurysm.<br>The patient was a 43-year-old man with syphilitic and human immunodeficiency virus (HIV) co-infection. Computed tomography (CT) revealed an aortic aneurysm with 89 mm in maximum size which was located at distal aortic arch and was considered syphilis derived saccular aneurysm. The aneurysm was judged at high risk of rupture from its shape. We decided to perform stent-graft implantation. Before surgery, the patient was given antibacterial and anti-HIV agents. Hand-made fenestrated stent graft by Tokyo Medical University was implanted. The graft was placed from the ascending aorta to Th 9 level in the descending aorta. The aneurysm completely disappeared during follow-up, with no flare-up of syphilitic infection up to 2 years after surgery.<br>The number of patients with syphilis and human immunodeficiency virus co-infection is now increasing. Stent-graft implantation may be an effective treatment in such immunocompromised patients.

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