Extra-anatomic autologous reconstruction with hepatic-iliac artery bypass graft for aortic endograft infection

Abstract

We present a new intra-abdominal extra-anatomic bypass graft for a 64-year-old man treated with an abdominal aortic endograft and with signs of endograft infection. We performed surgical removal of the endograft and intra-abdominal extra-anatomic reconstruction of a hepatic-to-right external iliac artery bypass with autologous superficial femoral vein and a crossover graft between the right and left external iliac artery with the great saphenous vein. The later occlusion of the saphenous vein graft led us to perform a femoral-femoral prosthetic crossover. At 42 months from the intervention, the patient was in good health, and duplex scanning confirmed the patency of all grafts.

Leriche Syndrome with Digital Gangrene: Is Aortic Bypass Grafting Safe in Intravenous Drug Abusers? A Case Report and Literature Review

“…However, placement of a prosthetic graft in the abdomen, pelvis, or groin carries the risk of catastrophic graft infection, particularly in the case of intravenous (IV) drug abusers, with a significant increase in morbidity and mortality [ 2 , 3 ]. Likewise, the introduction of bacteria into the bloodstream through inadvertent arterial cannulation or repeated venipuncture under nonsterile settings in IV drug abuse can also infect the endovascular material [ 4 ]. Although the overall reported incidence of prosthetic material infection in AIOD is low (<1%-3%), the incidence secondary to IV drug abuse is unknown [ 5 ].…”