Repair of mycotic paravisceral aneurysm with a fenestrated stent-graft

Purpose: To report the successful endovascular repair of a mycotic paravisc eral aneurysm using a fenestrated stent-graft. Methods and Results: A 55-year-old white female with a history of rheumatoi d arthritis presented with an 8-cm paravisceral aneurysm secondary to pneum onia complicated by empyema. Intravascular ultrasound identified a defect i n the aortic wall at the level of the celiac axis. Repair was accomplished with a fenestrated stent-graft that excluded the aneurysm and maintained fl ow to the celiac axis and superior mesenteric artery. Recovery was uneventf ul and the patient was discharged in 2 days. Six-month follow-up computed t omographic scanning confirmed aneurysm exclusion and flow to the celiac and superior mesenteric arteries. There was no evidence of graft infection. Th e patient died from a clinically diagnosed myocardial infarction 10 months after the stent-graft repair. Conclusions: Fenestrated stent-graft repair may evolve into a useful techni que for the treatment of mycotic paravisceral aneurysms.