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Endovascular salvage of tubercular aortitis presenting as descending thoracic aortic pseudoaneurysm in association with vertebral tuberculosis
  1. Rohit Mehra1,
  2. Rishi Dhillan2 and
  3. Sushma Manral3
  1. 1Department of Vascular and Endovascular Surgery, Command Hospital (Southern Command), Pune, Maharashtra, India
  2. 2Department of Vascular and Endovascular Surgery, Army Hospital (Research and Referral), New Delhi, New Delhi, India
  3. 3Department of Radiodiagnosis, Holy Family Hospital, New Delhi, India
  1. Correspondence to Dr Rohit Mehra; capocrimini.rohit{at}gmail.com

Abstract

A gentleman in his late 30s presented with a history of evening rise of temperature and generalised malaise of 1-week duration. He had associated upper back pain with tingling and numbness of both lower limbs. An unexplained episode of hypotension with hemoptysis propelled a computed tomography (CT) examination of chest which was suggestive of a pseudoaneurysm of the posterior wall of descending thoracic aorta in the vicinity of the Pott’s spine with a prevertebral and paravertebral abscess, for which he was referred to vascular surgeons.

Tubercular involvement of vasculature is a rare disease, aortic involvement even rarer. Less than 50 cases of vertebral tuberculosis with tubercular thoracic aortic aneurysm have been reported in the medical literature, but the disease carries a colossal mortality and morbidity.

After a multidisciplinary teamwork, thoracic endovascular aortic repair was done for exclusion of the aneurysmal segment, with simultaneous antitubercular and broad-spectrum antibiotic chemotherapy. The patient recuperated well.

  • vascular surgery
  • tuberculosis

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Footnotes

  • Contributors RM was involved in planning, conducting and reporting. RD was involved in planning and conducting. SM was involved in reporting.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.