Abdominal Aortic Rupture and Spondylodiscitis: Emergent EVAR and Staged Spinal Fixation

• Published in: Annals of vascular surgery Vol. 28; no. 5; pp. 1312.e7 - 1312.e11
• Main Authors: Capoccia, Laura, Menna, Danilo, Montelione, Nunzio, Tarantino, Roberto, Marruzzo, Daniele, Sbarigia, Enrico, Speziale, Francesco
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.07.2014
• Subjects: Aged; Aortic Aneurysm, Abdominal - complications; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - surgery; Aortic Rupture - complications; Aortic Rupture - diagnosis; Aortic Rupture - surgery; Aortography; Blood Vessel Prosthesis; Discitis - complications; Discitis - diagnosis; Discitis - surgery; Endovascular Procedures - methods; Follow-Up Studies; Humans; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Orthopedic Procedures - methods; Stents; Surgery; Tomography, X-Ray Computed
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1016/j.avsg.2013.08.029

Concomitant aortic aneurismal pathology and vertebral erosion are seldom reported in literature. The differential diagnosis between a primary vertebral disease affecting the aortic wall and a primary aortic pathology causing a vertebral disruption is quite difficult. We report on a patient presenting with increasing lumbar pain and neurologic lower limbs deficit due to a vertebral erosion accompanied by aortic rupture treated by emergent endovascular aortic repair procedure and then staged vertebral fixation. Microbiological tests on intraoperative periaortic fluid collection samples showed no clear sign of infection and clinical conditions progressively improved. At 12-month follow-up, the patient is in good clinical condition, with a small residual walking impairment and no clinical, laboratory, or imaging sign of aortic endograft infection.