Management Of Infected Pseudoaneurysms Research Articles

An out of the box treatment for an infected pseudoaneurysm: Deep to superficial femoral artery transposition.

An infected pseudoaneurysm is a condition that has become more common in recent years, with the proliferation of endovascular intervention and the use of intravenous drugs. If left untreated, an infected pseudoaneurysm can progress to rupture, which can lead to life-threatening hemorrhage. No clear consensus has been reached among vascular surgeons regarding the management of infected pseudoaneurysms, and the literature describes a wide range of treatment techniques. In the present report, we describe an "out of the box" approach to infected pseudoaneurysms: a superficial femoral artery to deep femoral artery transposition, as an alternative to ligation with or without bypass reconstruction. We also describe our experience with six patients who underwent this procedure with 100% technical success and limb salvage rates. Although we implemented this technique for cases of infected pseudoaneurysms, we believe it can also be applied to other cases of femoral pseudoaneurysms when angioplasty or graft reconstruction is not feasible. However, further research with larger cohorts is warranted.

Emergency Hybrid Repair of an Infected Pseudo-aneurysm of an Axillary Dialysis Necklace Graft

Excision of infected synthetic haemodialysis grafts with arterial repair can be extremely challenging due to friable vessels. We present a case of an infected pseudo-aneurysm of a synthetic necklace dialysis graft, where surgical repair of the axillary artery was attempted but not technically feasible. Emergency endovascular covered stenting was performed and the patient has now been free of complications for 4 years. Placing covered stents at infected sites remains controversial but we support endovascular treatment as a viable alternative in the emergency management of infected pseudo-aneurysms related to synthetic grafts and report long term good results in this case.

Surgical treatment of infected pseudoaneurysms after replacement of the ascending aorta

The best management of infected pseudoaneurysms after prosthetic graft replacement of the ascending aorta has not yet been established. The successful surgical treatment of three patients with this complication following replacement of the aortic valve and ascending aorta is reported. Because of the poor preoperative clinical condition of these patients, an effort was made to carry out the operative repair as expeditiously as possible. The prosthetic material was never entirely removed and replaced, but less radical operations were performed in combination with extensive and accurate debridement of the mediastinum and local antiseptic irrigation.