Tubercular Pseudoaneurysms of Aorta and its Branches

Introduction: Mycobacterial infection is a rare but definite cause of pseudoaneurysms of aorta and its branches worldwide in association with acquired immunodeficiency syndrome and drug-resistant tuberculosis (TB).

Patients and Methods: In the last decade, we treated 28 pseudoaneurysms of the aorta and its branches in 27 patients. All had evidence of treated or active TB (History of active or treated pulmonary TB, n = 23, meningeal TB, n = 1, military TB, n = 1, treated abdominal TB, n = 1, and treated cuteneous TB, n = 1). 11 patients had radiological or laboratory evidence of TB. Almost all parts of aorta were involved, commonest being distal arch (n = 6) and suprarenal abdominal aorta (n = 6). In 3 patients, innominate artery and in one the left common carotid artery was involved. Twenty four patients underwent surgery. Histopathological examination revealed granulo-matous inflammation in six patients. Four patients had positive culture for acid-fast bacilli. All patients received anti-TB chemotherapy following surgery.