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Case Report: Brucella-associated complications following thoracic endovascular aortic repair: a case series of three patients

Year: 2026

Type: article

Abstract: Background: Brucellosis is a rare but potentially fatal cause of vascular graft infection. Evidence regarding Brucella-associated complications after thoracic endovascular aortic repair (TEVAR) remains limited. Case presentation: We report three elderly male patients who developed severe aortic complications following TEVAR, including pseudoaneurysm formation and aorto-esophageal fistula. All patients had a history of epidemiological exposure to Brucella and were diagnosed with active infection through serological testing (Rose Bengal test, serum agglutination test, Brucella IgG and IgM antibodies). Endovascular re-intervention combined with targeted anti-brucellosis therapy was performed in all cases. Results: One patient achieved sustained clinical remission after repeat endovascular repair and prolonged antimicrobial therapy. Two patients developed catastrophic infectious complications, including mediastinal abscess and aorto-esophageal fistula, resulting in death despite aggressive management. Conclusions: Brucella infection should be considered in patients presenting with unexplained symptoms after TEVAR, especially in endemic regions. Endovascular repair plays a critical role in acute stabilization; however, long-term outcomes remain highly dependent on effective infection control.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2026.1885416