ABSTRACT
BACKGROUND: Complete eversion of the femoral tripod is interesting to reduce clinical consequences of wound infection, in particular for patients at a high risk (e.g., obese, diabetics, cancer). Experience and follow-up of this technique are scarce. The different technical possibilities and results are reported here. METHODS: A single-center prospective study including patients operated on for femoral occlusive lesions using eversion of the common femoral artery and its bifurcation. Clinical and imaging preoperative data, surgical technique, and follow-up are detailed. RESULTS: Thirty five patients (37 limbs) have been included between June 2014 and April 2016. The mean Rutherford index was 3.6 and 65% of the patients were claudicants. Lesions were limited to the common femoral artery in 14 (38%) of the cases and spread to the superficial femoral artery in 2 (7%) and to the 3 branches in 21 (57%) of the cases, respectively. Postoperatively, one death, one major amputation, and 3 reinterventions were noted, resulting in an 8% rate of major complications. The mean follow-up was 37 months. At this time, 11 major adverse cardiovascular events, 9 deaths, and no additional major amputation were noted. The mean Rutherford index was 1.7 (P < 0.001) and 3 reinterventions were necessary (one for septic occlusion at 3 months and 2 for restenosis at 12 and 42 months), translating into primary and secondary patency rates of 93.3% and 96.1%, respectively. CONCLUSIONS: This work further confirms that eversion of the femoral tripod is safe and effective. This experience adds to the existing body of the literature and describes alternative techniques of eversion. The technique should be considered when treating patients at a high risk of postoperative infection.
Subject(s)
Arterial Occlusive Diseases , Femoral Artery , Humans , Femoral Artery/diagnostic imaging , Femoral Artery/surgery , Prospective Studies , Follow-Up Studies , Vascular Patency , Treatment Outcome , Arterial Occlusive Diseases/surgery , StentsABSTRACT
Popliteal artery entrapment syndrome (PAES) is a rare condition, and its long-term outcome after surgical treatment is scarcely reported. We report the case of an aneurysmal degeneration of a venous bypass performed to treat PAES, which ultimately led to rupture. Hybrid treatment combining embolization and surgery resulted in favorable outcome. This case emphasizes the need for long-term follow-up after surgical treatment of PAES.
Subject(s)
Aneurysm, Ruptured/etiology , Arterial Occlusive Diseases/surgery , Popliteal Artery/surgery , Saphenous Vein/transplantation , Vascular Grafting/adverse effects , Aneurysm, Ruptured/diagnostic imaging , Aneurysm, Ruptured/physiopathology , Aneurysm, Ruptured/therapy , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/physiopathology , Collateral Circulation , Combined Modality Therapy , Computed Tomography Angiography , Embolization, Therapeutic , Humans , Male , Middle Aged , Popliteal Artery/diagnostic imaging , Popliteal Artery/physiopathology , Regional Blood Flow , Reoperation , Saphenous Vein/diagnostic imaging , Saphenous Vein/physiopathology , Time Factors , Treatment OutcomeABSTRACT
The antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis mainly affect small vessels. They are an exceptional etiology of visceral artery aneurysms, which are themselves unusual and potentially serious vascular disease. We report the case of a patient followed for vasculitis associated with ANCA with kidney disease who presented with symptomatic aneurysm of the inferior mesenteric artery and aneurysm of the superior mesenteric artery.
