Spontaneous rupture of superficial femoral artery repaired with endovascular stent-grafting with use of rendez-vous technique, followed by delayed infection

Superficial femoral artery-anterior tibial artery bypass with great saphenous vein grafting via the lateral femoropopliteal route for infection after Viabahn placement

We report a case involving an elderly man who successfully underwent superficial femoral artery-anterior tibial artery bypass via the lateral femoropopliteal route following development of a stent infection after placement of a small-diameter covered stent for a ruptured superficial femoral artery pseudoaneurysm. This report suggests that appropriate treatment strategies for device infection subsequent to device removal are paramount for the prevention of reinfection and preservation of the affected extremity.

Spontaneous Transection of the Superficial Femoral Artery with Devastating Outcomes: A Case Report

Non-traumatic, simultaneous pseudoaneurysms of the bilateral superficial femoral arteries (SFAs) are extremely rare. Spontaneous transection of the SFA is another unique pathology. Here, we present a patient with end stage kidney disease who was diagnosed with bilateral, simultaneous SFA pseudoaneurysms. He had a recent history of methicillin-sensitive Staphylococcus aureus septicemia; therefore, infection was suspected to be the main cause. Complete transection of the SFA was noted during the operative exploration of the symptomatic left side. Wide debridement and autologous vein bypass were performed via a clean route. Unfortunately, two months later, recurrent surgical site infection caused distal anastomotic rupture and fatal sepsis.

Spontaneous Anterior Tibial Artery Avulsion and Tibio-Peroneal Trunk Transection Resulting into a Pseudoaneurysm: A Case Report

Patient: Female, 53

Final Diagnosis: Spontaneous non-traumatic anterior tibial artery avulsion and tibio-peroneal trunk transection

Symptoms: Pain

Medication: —

Clinical Procedure: Autogenous popliteal-tibioperoneal trunk bypass

Specialty: Surgery

Use of Self-Expanding Covered Stents as Bailout Treatment of Spontaneous Rupture of the Femoral Artery Caused by Staphylococcus aureus Infection

Spontaneous rupture of femoropopliteal arteries caused by infection requires treatment in the urgent setting. The present article reports on the performance of self-expanding covered stents in 3 patients who experienced acute rupture of the femoral artery caused by Staphylococcus aureus infection. After a mean follow-up of 16.4 months, the bailout placement of self-expanding covered devices showed sustained patency and sufficient exclusion of the rupture site. A surgical conversion and bypass reconstruction was not necessary. Long-term follow-up and inclusion of more patients are needed to provide more evidence about the utility of this approach.

Combined transcatheter managements of a huge spontaneous iliac pseudoaneurysm presenting with fever of unknown origin: a case report

Introduction

We present a successful combined endovascular repair of a rare huge spontaneous pseudoaneurysm in a patient troubled solely with fever of unknown origin.

Case presentation

A 79-year-old Chinese man complained of repeated episodes of fever for 10 days. His medical history, physical examination and laboratory tests were not significant. Routine antibiotics were given for suspected sepsis lasting 4 weeks without clinical improvement. Finally, an 81.9×61.6mm iliac pseudoaneurysm was found. The pseudoaneurysm originated from his left iliac arteries and covered the bifurcation of the left common iliac artery and proximal ends of both internal and external iliac arteries. A combination of endovascular repair with coil embolization and stent graft implantation was successfully performed. He underwent an uneventful recovery.

Conclusions

Spontaneous pseudoaneurysm with fever of unknown origin should not be ignored, especially for patients with a high risk for atherosclerosis. Combined transcatheter managements might be an alternative approach to deal with complex pseudoaneurysms, effectively and safely.

Spontaneous rupture of superficial femoral artery

A 77-year-old man with a history of hemodialysis was referred due to swelling of the right groin. Enhanced computed tomography (CT) showed extravasation of the medium from the superficial femoral artery (SFA) with surrounding large hematoma. Three-dimensional CT angiography revealed rupture of SFA just distal to common femoral artery with pseudoaneurysmal formation. At an emergent surgery, SFA was ruptured over 1/2 circumferentially in a 2-cm length. Patch repair using great saphenous vein was performed successfully. Postoperative CT angiography showed no aneurysmal formation. Histopathological findings of operative specimen disclosed no sign of infection or arteriolitis.