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Letters to the Editor

Treatment of ruptured tuberculous aortic aneurysms

Department of Internal Medicine, Tenon Hospital, AP-HP, 4 rue de la Chine, 75020 Paris, France

Received 1 June 2008; accepted 3 July 2008.

^_* Corresponding author. Address: Service de Médecine Interne, Hôpital Tenon, 4 rue de la Chine, F-75020 Paris, France. Tel.: +33 1 56 01 60 33; fax: +33 1 56 01 70 82. (Email: olivier.steichen{at}tnn.aphp.fr).

Key Words: Cardiovascular tuberculosis • Thoracic aortic aneurysm • False aneurysm • Stents

The introduction of the case report ‘Conservative treatment for rupture of thoracic aortic aneurysm’ by Namai and Sakurai is somewhat misleading [1]. Four references are cited to support the statement that tuberculous involvement of blood vessels is rare, which is true but off-topic. Indeed, the reported aneurysm was not caused by tuberculosis; it merely involved a patient with a history of lung tuberculosis. The authors even suggest that this healed tuberculosis was beneficial, because residual fibrous scars around the aorta might have contained the bleeding from the ruptured aneurysm.

It should be emphasised that the treatment of tuberculous aortic aneurysms, unlike the reported case, combines antitubercular drugs and aortic repair [2]. Surgical repair and debridement of surrounding infected tissues is the best option. However, successful endovascular repair has been reported in a case of tuberculous aneurysm of the aortic isthmus without adjacent infected tissue [3]. Endovascular repair is also a palliative alternative when surgery is impossible or refused by the patient [4].

References

1. Namai A, Sakurai M. Conservative treatment for rupture of thoracic aortic aneurysm. Eur J Cardiothorac Surg 2008;33:1146-1147.[Abstract/Free Full Text]
2. Long R, Guzman R, Greenberg H, Safneck J, Hershfield E. Tuberculous mycotic aneurysm of the aorta: review of published medical and surgical experience. Chest 1999;115:522-531.[CrossRef][Medline]
3. Steichen O, Pellerin O, Frank M, Emmerich J, Sapoval M, Fiessinger JN, Bura-Rivière A. Endovascular repair of a tuberculous aortic false aneurysm. Rev Med Interne 2007;28:196-198.[Medline]
4. Labrousse L, Montaudon M, Le Guyader A, Choukroun E, Laurent F, Deville C. Endovascular treatment of a tuberculous infected aneurysm of the descending thoracic aorta: a word of caution. J Vasc Surg 2007;46:786-788.[CrossRef][Medline]

This article has been cited by other articles:

				M. Sakurai and A. Namai Reply to Steichen. Survival from ruptured aortic aneurysm without any operations Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 928 - 928. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Steichen, O. Search for Related Content PubMed Articles by Steichen, O. Related Collections Great vessels