Hybrid Repair of Infected Femoral Artery Pseudoaneurysm: Stent Graft Placement and Artificial Graft Replacement.

Autor:	Yamauchi H; Cardiovascular Surgery, Nagoya Tokushukai General Hospital, Kasugai, JPN., Kageyama S; Cardiovascular Surgery, Nagoya Tokushukai General Hospital, Kasugai, JPN., Kojima A; Cardiovascular Surgery, Nagoya Tokushukai General Hospital, Kasugai, JPN., Morita H; Cardiovascular Surgery, Nagoya Tokushukai General Hospital, Kasugai, JPN., Ohashi T; Cardiovascular Surgery, Nagoya Tokushukai General Hospital, Kasugai, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 29; Vol. 16 (7), pp. e65657. Date of Electronic Publication: 2024 Jul 29 (Print Publication: 2024).
DOI:	10.7759/cureus.65657
Abstrakt:	A femoral artery pseudoaneurysm is the most prevalent complication of femoral access due to the artery's accessibility and frequent use for catheterization and blood tests. An infected femoral artery pseudoaneurysm is often life-threatening and challenging to manage. A 70-year-old male with a history of tongue cancer treatments, including resection, lymph node dissection, and radiation chemotherapy, visited his previous physician for a fever and was prescribed oral antibiotics, but the fever persisted, accompanied by pain and a mass in the left groin. An enhanced CT revealed an infected pseudoaneurysm of the left femoral artery. The fever's etiology was unclear but likely stemmed from a blood draw from the femoral artery during a prior visit, resulting in a pseudoaneurysm that became infected. The patient was transferred to our hospital due to management challenges. Blood cultures from the previous hospital were positive, and laboratory tests indicated an active infection. The initial strategy was to continue antibiotic therapy to control the infection. After approximately a month of antibiotic treatment, blood cultures remained negative, and laboratory results improved significantly. However, the aneurysm had clearly enlarged, necessitating emergency surgery. Typically, surgical intervention requires opening the abdomen to replace the external iliac artery to its extent, a considerably invasive procedure for the patient. Thus, we opted for a hybrid treatment, implanting a stent graft from the external iliac artery to the proximal common femoral artery and replacing artificial blood vessels from there to the femoral artery bifurcation. The postoperative course was favorable. In this case, we provided the optimal treatment for the patient's condition, despite the impossibility of a radical cure due to the cancer's progression. We believe the infected pseudoaneurysm was adequately controlled, and the hybrid therapy is effective for patients who cannot endure more invasive treatments. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Yamauchi et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu