An Infected Aneurysm of the Vertebral Artery Treated with a Stent-graft: A Case Report

• Published in: Neurologia medico-chirurgica Vol. 55; no. 11; pp. 852 - 855
• Main Authors: HASHIMOTO, Kenji, ISAKA, Fumiaki, YAMASHITA, Kohsuke
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 2015
• Subjects: Aged; aneurysm; Aneurysm, Infected - diagnostic imaging; Aneurysm, Infected - therapy; Angiography; Aspirin - therapeutic use; Case Report; Drug Combinations; Humans; Male; Platelet Aggregation Inhibitors - therapeutic use; stent-graft; Stents; Ticlopidine - analogs & derivatives; Ticlopidine - therapeutic use; Tomography, X-Ray Computed; vertebral; Vertebral Artery
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.cr.2015-0046

In a 75-year-old man, a growing vertebral artery aneurysm at the C3/4 intervertebral level was found at postoperative evaluation of cervical abscess, which was diagnosed as a complication of sepsis subsequent to cholangitis. Even after a successful antibiotic treatment and a surgical drainage, the aneurysm grew enough to cause compression of esophagus and trachea. The aneurysm was judged to be infection-related, based on the clinical course and the anatomical vicinity to the abscess. Following a dual antiplatelet treatment (clopidogrel 75 mg and aspirin 100 mg per day) for a week, the patient underwent endovascular treatment of the aneurysm with a stent-graft. Postoperative angiography showed complete obliteration of the aneurysm with preserving patency of the vertebral artery. A dual antiplatelet treatment was continued for 6 months and was changed to a single antiplatelet treatment (clopidogrel 75 mg per day) thereafter. Neither recurrence of the aneurysm nor stent-graft infection was observed for 4 years of follow-up. This case illustrates the potential use of a stent-graft in the treatment of an infected aneurysm.