Vasc Spec Int.  2014 Jun;30(2):72-75. 10.5758/vsi.2014.30.2.72.

In Situ Aortic Reconstruction with Femoral Vein after Post-EVAR Infection

• Shin HK
• Park JY
• Lee T

• KMID: 1803149
• DOI: http://doi.org/10.5758/vsi.2014.30.2.72

Abstract

A 78-year-old male presented with early gastric cancer and a 5.5 cm-sized infrarenal abdominal aortic aneurysm, detected during regular screening. Endovascular aneurysm repair (EVAR) was performed first, followed by laparoscopic distal gastrectomy. After gastrectomy, the patient underwent computed tomography (CT) scan due to persistent fever, which showed increased perigraft fluid collection around the right iliac limb graft. Echocardiography also revealed mitral valve vegetation, consistent with infective endocarditis. Despite intensive antibiotic treatment, the patient had persistent fever and showed fluid extension to the psoas muscle on CT scan. On the 49th post operative day (POD) after EVAR, stent graft explantation and aortic reconstruction with the left superficial femoral vein was performed. Ligation of the right iliac artery for infection control and simultaneous femoro-femoral bypass was also performed. The patient was discharged on the 46th POD after graft removal without any events.

Keyword

Abdominal aortic aneurysm; Endovascular procedures; Prosthesis-related infections; Femoral vein

MeSH Terms

Aged
Aneurysm
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis
Echocardiography
Endocarditis
Endovascular Procedures
Extremities
Femoral Vein*
Fever
Gastrectomy
Humans
Iliac Artery
Infection Control
Ligation
Male
Mass Screening
Mitral Valve
Prosthesis-Related Infections
Psoas Muscles
Stomach Neoplasms
Tomography, X-Ray Computed
Transplants