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Capnocytophaga canimorsus in Iliac Artery Mycotic Aneurysm: The Role of Molecular Diagnostics.

Am J Case Rep

January 2025

Vascular and Endovascular Surgery, Department of Cardiovascular Surgery, Mayo Clinic Health System, Eau Claire, WI, USA.

BACKGROUND The bacterial organism Capnocytophaga canimorsus is an oral commensal of cats and dogs and can cause life-threatening infections like mycotic aneurysm, meningitis, and sepsis. Mycotic aneurysms occur when microbial infections cause arterial wall degeneration. Difficulty in diagnosing Capnocytophaga canimorsus infection can occur due to the bacteria's fastidious nature and laboratory testing limitations, contributing to the infection's high morbidity and mortality.

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A 50-year-old female presented with a 10-day history of progressive swelling and pain in the left lower extremity, ultimately diagnosed with deep vein thrombosis (DVT) and May-Thurner Syndrome (MTS). Initial ultrasound indicated thrombosis involving the left external iliac, femoral, and popliteal veins, among others. Blood tests revealed normocytic anemia, but thrombophilia screening and other blood markers were normal.

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Purpose: The use of surgeon-modified fenestrated endograft to treat a bleeding complication in the common iliac artery.

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We document a case of a 75-year-old patient with a history of hypercholesterolemia and hypertension, who underwent endovascular aortic repair (EVAR) for an infrarenal abdominal aortic aneurysm (AAA) with common iliac artery ectasia. Despite an initially successful procedure, the patient experienced recurrent episodes of acute limb ischemia in his right leg. Subsequent imaging revealed thrombus formation distal to the stent graft, constituting a potential source of embolization, which warranted a reevaluation of the treatment strategy.

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Mechanical valve leaflets have the potential to detach and migrate to unintended locations, leading to life- and limb-threatening situations. We report a unique case of a dislodged mechanical aortic valve leaflet in the right iliac artery bifurcation after a redo mitral valve replacement. This was promptly recognized by input from a multidisciplinary team, allowing immediate correction of the aortic valve insufficiency followed by staged retrieval of the dislodged leaflet to avoid vascular complications.

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