Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

Pecoraro, Felice; Sabatino, Ermanno R.; Dinoto, Ettore; Rosa, Giuliana La; Corte, Giuseppe; Bajardi, G

doi:10.1007/s00270-014-0970-6

Cited by 15 publications

(8 citation statements)

References 8 publications

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“…After the first surgical procedure, if a significant hemodynamic lesion is found, a new procedure, via an endovascular or surgical approach can improve secondary patency [ 11 ]. More surgeons have incorporated the concepts of intraoperative angiography and endovascular treatment into their open vascular surgery to enhance the surgical results, minimize the surgical invasiveness and maintain graft patency, preventing limb loss [ [12] , [13] , [14] ].…”

Section: Discussionmentioning

confidence: 99%

Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report

Dinoto

Bajardi

Marca

et al. 2021

International Journal of Surgery Case Reports

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Introduction Peripheral Arterial Disease (PAD) in diabetic patients is a significant cause of Morbility. Long arterial occlusion in patient previously treated can require unusual and complex solution. Herein we report a case of complicated bypass in diabetic patient with history of bypass for bilateral popliteal aneurysm. Presentation of case A 51-year-old male, smoker, with hypertension and diabetes mellitus was referred to our hospital for rest pain in left limb and peripheral cyanosis. Ultrasound doppler (US) showed an occlusion after common femoral artery with patency of Anterior-tibial artery (ATA) two centimeters after the origin. The unavailability of adequate autologous conduit necessitated an alternative solution and was chosen a composite femoro-anterior tibial artery bypass with successive ATA angioplasty to ensure the patency of graft. Discussion The autogenous vein is the preferred conduit in below-knee vascular reconstructions but in redo-procedures in the absence of vein, synthetic or biologic vascular prostheses must be considered as graft material. In these cases tibial angioplasty can improve the outflow and the patency. Conclusion Composite Femoro-ATA bypass with tibial angioplasty is an alternative technique for critically ischemic legs with limited autologous vein material. In our experience this approach was safe and effective.

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Section: Discussionmentioning

confidence: 99%

Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report

Dinoto

Bajardi

Marca

et al. 2021

International Journal of Surgery Case Reports

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“…Diabetes and smoking independently increase the infection risk; however, other risk factors previously reported for endovascular procedures, such as absence of sterility, lack of antibiotic prophylaxis, introducer sheath permanence more than 24 h, multiple stents implantation, or multiple procedures in the same region [ 10 ], and in our case a bare metal stent was present for a precedent FSA stenting. Infected stent and/or stent-graft usually appear as device thrombosis, septic embolization, pseudoaneurysm, and hemorrhage [ 11 , 12 ]. The clinical presentation of our case was an infected fistula with a suspect CT-scan for patch disconnection and stent dislocation outside the arterial wall.…”

Section: Discussionmentioning

confidence: 99%

Iliac-femoral stent-graft infection after hybrid procedure redo: Case report

Dinoto

Ferlito

Urso

et al. 2021

International Journal of Surgery Case Reports

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Introduction Stent-graft infection in peripheral arteries is rare and potentially dangerous. The use of hybrid procedures, in complicated patients previously treated, involves an increase of infective risk especially in no collaborative patients. Presentation of case We report a case of rare stent-graft infection in a patient treated for a Rutherford IV Multiple Peripheral Arterial Disease (MPAD) involving the right iliac-femoral axis with stenosis on deep femoral artery due to a previously stenting procedure for Superficial Femoral artery (SFA) stenosis. The first simultaneous hybrid intervention consisted of an endovascular iliac stent-graft placement and a surgical common femoral patch angioplasty. After two months the patient was readmitted to our unit for a purulent secretion through a fistulous channel and a suspect infection of stent-graft. Subsequently, the stent-graft was completely removed without possibility to have a surgical revascularization. An amputation major amputation was needed for irreversible ischemia of right leg. Discussion The incidence of stent-graft infection after endovascular aortic aneurysm repair had been reported as 0.4–1.0% while Aortoiliac graft infection occurs in 2–6% of patients. Hybrid procedures are secure and need close follow-up for cases of redo and patient with comorbidities. Conclusions Graft infection is a rare complication after endovascular treatments. Hybrid procedures outcomes are good with less morbidity but in patient with high risk of infection is important a close follow-up.

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“…The patient returned with 75% of the graft extruded outside the skin with surrounding granulomatous tissue infected with Staphylococcus aureus. 2 The authors suggested early stent-graft thrombosis and immunologic reaction as possible causes of extrusion and subsequent infection. In our case, the J o u r n a l P r e -p r o o f extruded stent did not breach the skin, and cultures were negative despite presence of fluid suggestive of infection.…”

Section: Discussionmentioning

confidence: 99%

Superficial femoral artery stent extrusion

Voruganti

Olowofela

Wood

et al. 2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

Cited by 15 publications

References 8 publications

Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report

Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report

Iliac-femoral stent-graft infection after hybrid procedure redo: Case report

Superficial femoral artery stent extrusion

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