Novel surgical reconstruction of a mycotic abdominal aortic aneurysm using cryopreserved femoral arterial allograft from the NHS tissue bank: a new resource for UK vascular surgeons

Abstract

The treatment of mycotic abdominal aortic aneurysms remains a significant surgical challenge associated with significant morbidity and mortality. In the following case report, we describe our successful management of a patient with a mycotic abdominal aortic aneurysm using two cryopreserved superficial femoral artery allografts (available from the UK NHS tissue bank) to create a Y-shaped allograft to permit immediate aortic reconstruction after surgical debridement. To our knowledge, this is the first time such a reconstruction has been reported in the literature. Case historyA 42-year-old man was admitted acutely to the medical admissions unit complaining of abdominal pain. He had a history of intravenous drug abuse, previous groin abscesses secondary to infected injection sites and bilateral lower limb deep vein thromboses (DVTs). He was pyrexial on admission and abdominal examination revealed a central nontender pulsatile mass. There was no evidence of any groin sepsis but both legs were swollen. Blood results revealed normocytic normochromic anaemia (Hb 9.3g/l) and raised inflammatory markers (WCC: 16.7 x 10 9

Management of primary mycotic aneurysms and prosthetic graft infections: an 8‐year experience with in‐situ cryopreserved allograft reconstruction

“…The Liverpool Tissue Bank in the UK prioritizes collection of the common and superficial femoral arteries for vascular surgical applications due to its versatility for both intra‐abdominal bypasses and for peripheral bypasses. Bypass grafts constructed from paired femoral arterial allografts have been shown to be suitable for reconstruction of long aorto‐bifemoral grafts 13,14 . At the time of writing of this report, there is no longer an operational cardiovascular tissue bank in the state of Queensland as the service is undergoing a government department review.…”