Aortic prosthesis infection is associated with significant morbidity and mortality rates. The introduction of the neo-aortoiliac system (NAIS) technique offers a new perspective, as a venous conduit is considered an optimal graft in aortic prosthesis infection because it is autogenous, durable, inexpensive and has low infection rates. Occasionally, the anatomical characteristics of available autologous venous conduits may limit the applicability of this technique. Herein, we present two cases in which a variant NAIS technique was used to confront an aortic graft infection. To expand the usefulness of the NAIS technique and avoid the use of prosthetic material in a potentially contaminated area as much as possible, we combined an autologous femoral vein with a short segment of a silver-coated Dacron graft. The combination of a silver-impregnated graft and the NAIS is a feasible bailout technique should the NAIS vein appears inadequate upon exploration.
In this report we present a case of a ruptured celiac artery aneurysm (CAA) with a thrombosed distal neck, which was treated as an emergently with a deployment of a tube thoracic endograft to the descending thoracic and upper abdominal aorta. The initial treatment was assisted with a second stage percutaneous, transhepatic, ultrasound guided needle infusion of coil and thrombin to the aneurysmal sac due to type Ib endoleak, with immediate thrombosis of the aneurysm. This technique, although not standard,could also be considered as a useful choice for the treatment of CAAs with wide proximal and patent distal neck.
Aortoenteric fistula is a rare condition. Atypical presentations may cause significant management delays. We present the case of a 64-year-old male who experienced a pathological femoral fracture as an initial presentation of an underlying aortoenteric fistula. The aortoenteric fistula, possibly related to a poor graft tunneling technique, induced femur osteomyelitis and the associated pathological fracture.
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