Hybrid Repair Combined with Fresh Arterial Allograft Extra-Anatomical Reconstruction: The Treatment of Infrarenal Abdominal Aneurysm above an Aortobifemoral Bypass Complicated by an Infected Pseudoaneurysm in the Left Groin
Introduction. A 72-year-old male patient was admitted into our centre with large infected pseudoaneurysm (PSA) in the left groin. The patient underwent a CT angiography (CTA) that confirmed a large partly thrombosed 6.5×5.5 cm PSA in the left groin arising from the distal anastomosis of the aortobif...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2020/8819305 |
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| author | Robert Novotny Tomas Marada Jiri Novotny Jakub Kristek Jaroslav Chlupac Michal Kudla Kvetoslav Lipar Jiri Mendl Jiri Fronek Libor Janousek |
| author_facet | Robert Novotny Tomas Marada Jiri Novotny Jakub Kristek Jaroslav Chlupac Michal Kudla Kvetoslav Lipar Jiri Mendl Jiri Fronek Libor Janousek |
| author_sort | Robert Novotny |
| collection | DOAJ |
| description | Introduction. A 72-year-old male patient was admitted into our centre with large infected pseudoaneurysm (PSA) in the left groin. The patient underwent a CT angiography (CTA) that confirmed a large partly thrombosed 6.5×5.5 cm PSA in the left groin arising from the distal anastomosis of the aortobifemoral bypass (ABF). Furthermore, the CTA revealed 11 cm juxtarenal abdominal aortic aneurysm (JAAA) from which the proximal anastomosis of the ABF was arising. Method. Aorto-uni-iliac stent graft Cook was placed from the right groin trough native severely stenotic right iliac arteries with proximal landing zone below the renal arteries, excluding the JAAA and the ABF. The distal landing zone was in the common iliac artery maintaining patent right internal iliac artery. Afterwards, a femoro-femoral crossover bypass from right to left was performed using a fresh arterial allograft. Postprocedurally, the hospital stay was uneventful. The left groin PSA cultures came positive for Staphylococcus epidermidis and Corynebacterium tuberculostearicum, both sensitive to vancomycin and rifampicin. Result. The patient underwent intravenous ATB treatment with vancomycin for two weeks, followed by four weeks of oral rifampicin. The patient was discharged on the 20th postoperative days. Conclusion. Hybrid repair combining aortic stent graft and extra-anatomical bypass in the treatment of infected distal parts of an aortofemoral bypass is an acceptable treatment modality. |
| format | Article |
| id | doaj-art-d990cfc188284a0fbc5bc1c1a60731c1 |
| institution | Kabale University |
| issn | 2090-6986 2090-6994 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Vascular Medicine |
| spelling | doaj-art-d990cfc188284a0fbc5bc1c1a60731c12025-02-03T01:03:58ZengWileyCase Reports in Vascular Medicine2090-69862090-69942020-01-01202010.1155/2020/88193058819305Hybrid Repair Combined with Fresh Arterial Allograft Extra-Anatomical Reconstruction: The Treatment of Infrarenal Abdominal Aneurysm above an Aortobifemoral Bypass Complicated by an Infected Pseudoaneurysm in the Left GroinRobert Novotny0Tomas Marada1Jiri Novotny2Jakub Kristek3Jaroslav Chlupac4Michal Kudla5Kvetoslav Lipar6Jiri Mendl7Jiri Fronek8Libor Janousek9Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicTransplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicTransplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicTransplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicTransplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicTransplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicTransplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicTransplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicTransplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicIntroduction. A 72-year-old male patient was admitted into our centre with large infected pseudoaneurysm (PSA) in the left groin. The patient underwent a CT angiography (CTA) that confirmed a large partly thrombosed 6.5×5.5 cm PSA in the left groin arising from the distal anastomosis of the aortobifemoral bypass (ABF). Furthermore, the CTA revealed 11 cm juxtarenal abdominal aortic aneurysm (JAAA) from which the proximal anastomosis of the ABF was arising. Method. Aorto-uni-iliac stent graft Cook was placed from the right groin trough native severely stenotic right iliac arteries with proximal landing zone below the renal arteries, excluding the JAAA and the ABF. The distal landing zone was in the common iliac artery maintaining patent right internal iliac artery. Afterwards, a femoro-femoral crossover bypass from right to left was performed using a fresh arterial allograft. Postprocedurally, the hospital stay was uneventful. The left groin PSA cultures came positive for Staphylococcus epidermidis and Corynebacterium tuberculostearicum, both sensitive to vancomycin and rifampicin. Result. The patient underwent intravenous ATB treatment with vancomycin for two weeks, followed by four weeks of oral rifampicin. The patient was discharged on the 20th postoperative days. Conclusion. Hybrid repair combining aortic stent graft and extra-anatomical bypass in the treatment of infected distal parts of an aortofemoral bypass is an acceptable treatment modality.http://dx.doi.org/10.1155/2020/8819305 |
| spellingShingle | Robert Novotny Tomas Marada Jiri Novotny Jakub Kristek Jaroslav Chlupac Michal Kudla Kvetoslav Lipar Jiri Mendl Jiri Fronek Libor Janousek Hybrid Repair Combined with Fresh Arterial Allograft Extra-Anatomical Reconstruction: The Treatment of Infrarenal Abdominal Aneurysm above an Aortobifemoral Bypass Complicated by an Infected Pseudoaneurysm in the Left Groin Case Reports in Vascular Medicine |
| title | Hybrid Repair Combined with Fresh Arterial Allograft Extra-Anatomical Reconstruction: The Treatment of Infrarenal Abdominal Aneurysm above an Aortobifemoral Bypass Complicated by an Infected Pseudoaneurysm in the Left Groin |
| title_full | Hybrid Repair Combined with Fresh Arterial Allograft Extra-Anatomical Reconstruction: The Treatment of Infrarenal Abdominal Aneurysm above an Aortobifemoral Bypass Complicated by an Infected Pseudoaneurysm in the Left Groin |
| title_fullStr | Hybrid Repair Combined with Fresh Arterial Allograft Extra-Anatomical Reconstruction: The Treatment of Infrarenal Abdominal Aneurysm above an Aortobifemoral Bypass Complicated by an Infected Pseudoaneurysm in the Left Groin |
| title_full_unstemmed | Hybrid Repair Combined with Fresh Arterial Allograft Extra-Anatomical Reconstruction: The Treatment of Infrarenal Abdominal Aneurysm above an Aortobifemoral Bypass Complicated by an Infected Pseudoaneurysm in the Left Groin |
| title_short | Hybrid Repair Combined with Fresh Arterial Allograft Extra-Anatomical Reconstruction: The Treatment of Infrarenal Abdominal Aneurysm above an Aortobifemoral Bypass Complicated by an Infected Pseudoaneurysm in the Left Groin |
| title_sort | hybrid repair combined with fresh arterial allograft extra anatomical reconstruction the treatment of infrarenal abdominal aneurysm above an aortobifemoral bypass complicated by an infected pseudoaneurysm in the left groin |
| url | http://dx.doi.org/10.1155/2020/8819305 |
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