Arterial reconstruction of infected femoral artery pseudoaneurysms using superficial femoral-popliteal vein

Christopher L. Bell, Ahsan T. Ali, John G. Brawley, Victor J. D'Addio, J. Gregory Modrall, R. James Valentine, G. Patrick Clagett

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

BACKGROUND: Infected femoral artery pseudoaneurysms (IFAPs) secondary to percutaneous arterial access, injection of illegal substances, and from infected synthetic grafts, appear to be increasing in incidence. Ligation of IFAPs without revascularization offers control of infection but may risk limb ischemia. Revascularization with extraanatomic synthetic grafts may risk reinfection and abrupt thrombosis. Excision of IFAPs with revascularization using superficial femoral popliteal vein (SFPV) provides both control of infection and excellent limb perfusion. STUDY DESIGN: A retrospective review was conducted of patients diagnosed with IFAP who underwent resection and revascularization with SFPV at a single medical center. Outcomes measured included reinfection and amputation rate. These were compared with other series using various methods to treat IFAPs. RESULTS: Eleven patients with IFAP were encountered from 1992 to 2004. Mean age was 64 years (±10 SD). Five patients developed IFAP secondary to percutaneous arterial access procedures. Four patients developed infected femoral artery pseudoaneurysms secondary to synthetic graft infection. Two patients developed IFAP secondary to injection of illegal substances in the femoral region. All patients had positive wound cultures initially. Staphylococcus was the most common organism found in wound cultures. All patients underwent resection of IFAP with lower extremity revascularization using SFPV. There was no incidence of limb ischemia and no perioperative deaths in this series. CONCLUSIONS: Excision of IFAP with revascularization can be successfully achieved using SFPV. This method may prove to be superior to other methods with apparent higher patency rates and resistance to reinfection.

Original languageEnglish (US)
Pages (from-to)831-836
Number of pages6
JournalJournal of the American College of Surgeons
Volume200
Issue number6
DOIs
StatePublished - Jun 2005

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Popliteal Vein
Femoral Vein
False Aneurysm
Femoral Artery
Extremities
Infection Control
Transplants
Ischemia
Injections
Incidence
Wounds and Injuries
Thigh
Staphylococcus
Amputation
Ligation
Lower Extremity
Thrombosis

ASJC Scopus subject areas

  • Surgery

Cite this

Arterial reconstruction of infected femoral artery pseudoaneurysms using superficial femoral-popliteal vein. / Bell, Christopher L.; Ali, Ahsan T.; Brawley, John G.; D'Addio, Victor J.; Modrall, J. Gregory; Valentine, R. James; Clagett, G. Patrick.

In: Journal of the American College of Surgeons, Vol. 200, No. 6, 06.2005, p. 831-836.

Research output: Contribution to journalArticle

Bell, Christopher L. ; Ali, Ahsan T. ; Brawley, John G. ; D'Addio, Victor J. ; Modrall, J. Gregory ; Valentine, R. James ; Clagett, G. Patrick. / Arterial reconstruction of infected femoral artery pseudoaneurysms using superficial femoral-popliteal vein. In: Journal of the American College of Surgeons. 2005 ; Vol. 200, No. 6. pp. 831-836.
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N2 - BACKGROUND: Infected femoral artery pseudoaneurysms (IFAPs) secondary to percutaneous arterial access, injection of illegal substances, and from infected synthetic grafts, appear to be increasing in incidence. Ligation of IFAPs without revascularization offers control of infection but may risk limb ischemia. Revascularization with extraanatomic synthetic grafts may risk reinfection and abrupt thrombosis. Excision of IFAPs with revascularization using superficial femoral popliteal vein (SFPV) provides both control of infection and excellent limb perfusion. STUDY DESIGN: A retrospective review was conducted of patients diagnosed with IFAP who underwent resection and revascularization with SFPV at a single medical center. Outcomes measured included reinfection and amputation rate. These were compared with other series using various methods to treat IFAPs. RESULTS: Eleven patients with IFAP were encountered from 1992 to 2004. Mean age was 64 years (±10 SD). Five patients developed IFAP secondary to percutaneous arterial access procedures. Four patients developed infected femoral artery pseudoaneurysms secondary to synthetic graft infection. Two patients developed IFAP secondary to injection of illegal substances in the femoral region. All patients had positive wound cultures initially. Staphylococcus was the most common organism found in wound cultures. All patients underwent resection of IFAP with lower extremity revascularization using SFPV. There was no incidence of limb ischemia and no perioperative deaths in this series. CONCLUSIONS: Excision of IFAP with revascularization can be successfully achieved using SFPV. This method may prove to be superior to other methods with apparent higher patency rates and resistance to reinfection.

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