Subject(s)
Axillofemoral Bypass Grafting/adverse effects , Blood Vessel Prosthesis/adverse effects , Cutaneous Fistula/etiology , Graft Occlusion, Vascular/etiology , Prosthesis-Related Infections/etiology , Sepsis/etiology , Anti-Bacterial Agents/therapeutic use , Aorta/surgery , Axillofemoral Bypass Grafting/instrumentation , Computed Tomography Angiography , Cutaneous Fistula/diagnosis , Cutaneous Fistula/therapy , Device Removal , Graft Occlusion, Vascular/diagnosis , Graft Occlusion, Vascular/therapy , Humans , Male , Middle Aged , Prosthesis-Related Infections/diagnosis , Prosthesis-Related Infections/therapy , Sepsis/diagnosis , Sepsis/therapy , Thrombosis/surgeryABSTRACT
BACKGROUND: A traumatic non-anastomotic pseudoaneurysm is a rare complication of an axillofemoral bypass graft. Fewer than 20 cases have been reported in the literature. Our case is unusual in that we report a double localization of this complication. CASE PRESENTATION: We report the case of a 60-year-old Arabic male patient who was diagnosed with two hematomas in the trajectory of his axillofemoral bypass secondary to a traumatism. The diagnosis of a non-anastomotic pseudoaneurysm was retained considering the results of a computed tomography angiography scan, which showed the double localization of the pseudoaneurysm. Surgical management consisted of flattening the pseudoaneurysm along with the interposition of a prosthetic segment. There were no postoperative complications and our patient was well 3 years after discharge. CONCLUSIONS: Non-anastomotic pseudoaneurysm is a rarely described complication of a axillofemoral bypass graft. To the best of our knowledge, a double localization has not been described in the literature before. Minimally invasive techniques as a treatment option are being widely used as an alternative to open repair.
Subject(s)
Aneurysm, False/diagnostic imaging , Arterial Occlusive Diseases/diagnostic imaging , Axillary Artery/diagnostic imaging , Axillofemoral Bypass Grafting/adverse effects , Femoral Artery/diagnostic imaging , Tomography, X-Ray Computed , Aneurysm, False/physiopathology , Aneurysm, False/surgery , Arterial Occlusive Diseases/physiopathology , Arterial Occlusive Diseases/surgery , Axillary Artery/pathology , Axillary Artery/surgery , Femoral Artery/pathology , Femoral Artery/surgery , Humans , Male , Middle Aged , Postoperative Complications , Treatment OutcomeSubject(s)
Aneurysm, False/diagnostic imaging , Axillary Artery/surgery , Axillofemoral Bypass Grafting/adverse effects , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis/adverse effects , Femoral Artery/surgery , Prosthesis Failure/adverse effects , Aged , Aneurysm, False/etiology , Aneurysm, False/surgery , Axillary Artery/diagnostic imaging , Axillofemoral Bypass Grafting/methods , Blood Vessel Prosthesis Implantation/methods , Chronic Disease , Femoral Artery/diagnostic imaging , Humans , Male , Polytetrafluoroethylene , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Although endovascular therapy (EVT) has advanced, few reports have compared EVT and bypass surgery in claudication patients with femoropopliteal disease. The present study used data from a multicenter registry in Japan to analyze outcomes of EVT and bypass surgery for claudication patients with Trans-Atlantic Inter-Society Consensus (TASC)-II C and D femoropopliteal lesions. METHODS AND RESULTS: Of 1,156 patients who underwent revascularization, 696 patients were treated for intermittent claudication. A total of 263 patients with femoropopliteal lesion were classified into TASC-II C and D. The primary and secondary patency rates of the EVT and bypass surgery groups were analyzed. The overall complication rate was 14.4% in the bypass surgery group and 3.5% in the EVT group (P<0.01). The 1- and 5-year primary patency rates were 82.1% and 69.4% in the bypass surgery group and 67.8% and 45.2% in the EVT group, respectively. Although the bypass surgery group had a higher primary patency rate than the EVT group (P<0.01, log-rank test), secondary patency rates did not differ significantly between the two groups. CONCLUSIONS: Although bypass surgery is clearly feasible for claudication patients with TASC-II C and D femoropopliteal disease, EVT is also a good option because of its lower complication rate and good secondary patency rate in patients in poor condition for bypass.
