Abstract
We report a successful surgical case of endovascular stent-graft treatment and secondary abscess drainage via thoracotomy for infected thoracic pseudoaneurysm. A 73-year-old woman with colostomy and total pelvic exenteration for rectal cancer at the age of 71 received subsequent chemotherapy and radiation therapy. During treatment for sepsis and pyelonephritis, she complained of appetite loss and general fatigue. Echocardiography revealed cardiac effusion and pleural effusion. Computed tomography (CT) revealed a pseudoaneurysm of the thoracic descending aorta and left pleural effusion. She was successfully treated by a 2-stage hybrid surgical procedure consisting of endovascular stent-grafting with abscess resection and drainage with a small thoracotomy. She was discharged on day 60 after the abscess drainage with a drainage tube. Drainage tube removal was effective for 8 months following endovascular repair without an inflammatory response for infection. At 2 years after the endovascular repair, CT revealed the disappearance of the aneurysm and an abscess cavity. For patients with rupture of an infected thoracic aortic aneurysm, this 2-stage hybrid surgical procedure, consisting of endovascular stent graft repair and abscess drainage, can yield an acceptable long-term outcome.
