Infected Aortic Stent Graft with Aortitis



Infected Aortic Stent Graft with Aortitis


Katherine R. Birchard



CLINICAL HISTORY

67-year-old male with chest pain, hypotension, and elevated neutrophil count.






FIGURE 6A


FINDINGS

Figure 6A: Serial axial contrast-enhanced CT images of the chest show the aorta with stent graft, and irregular enhancing soft tissue surrounding the arch and descending thoracic aorta (yellow arrows).


DIFFERENTIAL DIAGNOSIS

Infected aortic stent graft with aortitis, acute mediastinal hematoma, small cell carcinoma.




DISCUSSION

Contrast-enhanced computed tomography angiography (CTA) is the first-line imaging modality when acute abnormalities of the aorta are suspected. Findings of infectious aortitis are abnormal periaortic soft tissue with adjacent fat stranding or fluid, and, less commonly, periaortic gas collections. Noncontrast images are also useful, because the periaortic soft tissue enhances with contrast, differentiating it from acute hematoma.1 Infectious aortitis typically occurs in a setting of an atherosclerotic aneurysm (mycotic aneurysm), but can also occur as a result of an infected stent graft, as in this case. Awareness and recognition of imaging findings associated with infected aneurysms are critical for early diagnosis and institution of adequate therapy, in view of the high risk of mortality. IV antibiotic therapy is critical, followed by possible stent removal and revascularization.2,3

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Jun 30, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Infected Aortic Stent Graft with Aortitis

Full access? Get Clinical Tree

Get Clinical Tree app for offline access