Usefulness of Gallium Scintigraphy in Follow up after Endovascular Aortic Repair for Mycotic Abdominal Aortic Aneurysm
- VernacularTitle:感染性腹部大動脈瘤に対するEVAR施行後の評価にガリウムシンチグラフィが有用であった1例
- Author:
Yuki OHTOMO
1
;
Yurie OHTOMO
1
;
Nobuyuki INOUE
2
;
Nobuyuki YAMAMOTO
1
Author Information
- Keywords: MAAA; EVAR; gallium scintigraphy
- From:Japanese Journal of Cardiovascular Surgery 2024;53(4):208-211
- CountryJapan
- Language:Japanese
- Abstract: Open surgery remains the treatment of choice for mycotic abdominal aortic aneurysm (MAAA). However, open surgery for MAAA is often associated with a significant perioperative risk and there have been some reports in which MAAA was successfully treated with endovascular aortic repair (EVAR). We report a case of MAAA treated with EVAR. Gallium scintigraphy was useful in postoperative evaluation of infection. A 61-year-old man presented with back pain. Computed tomography (CT) revealed a 50-mm saccular abdominal aortic aneurysm(AAA). The patient underwent EVAR for symptomatic AAA but developed a high fever 5 days after surgery. Serum C-reactive protein level was elevated and blood culture was positive for Salmonella. Intravenous antibiotics were commenced with a diagnosis of MAAA and the fever and inflammatory parameters subsided with a decrease in the size of the aneurysm. Accumulation of gallium was observed on scintigraphy 1 month after surgery. The patient received intravenous antibiotics for 8 weeks after surgery and was discharged home with oral antibiotics. At 6 months after surgery, accumulation of gallium disappeared. Oral antibiotics were ceased when CT showed disappearance of the aneurysm 9 months after surgery. At present, the patient has been doing well without signs or symptoms of recurrent infection.
