Low Morbidity Anatomical Revascularisation for an Infected Aorto-Bifemoral Graft Using a Staged Hybrid Procedure

Area of Science:

• Vascular Surgery
• Infectious Disease Management in Prosthetic Grafts
• Biomaterials in Vascular Repair

Background:

• Aortobifemoral bypass grafts are used to treat peripheral artery disease, but are susceptible to infection.
• Graft infection can lead to serious complications, including pseudoaneurysm formation.
• Managing infected grafts often requires complex surgical interventions.

Observation:

• A 66-year-old woman developed a right femoral false aneurysm secondary to an infected aortobifemoral bypass graft.
• Computed tomography (CT) angiography confirmed extensive graft infection.
• A two-stage hybrid surgical approach was employed for treatment.

Findings:

• The first stage involved excising femoral components, stenting the aortic stump, and recanalizing iliac arteries.
• The second stage included aortic graft explant and repair with a bovine pericardium patch.
• Post-operative imaging showed no residual infection, with the patient remaining complication-free at 12 months.

Implications:

• This hybrid strategy offers a safe and effective method for managing infected aortobifemoral bypass grafts.
• The use of bioprosthetic materials demonstrates promise in complex vascular reconstructions.
• This approach may reduce morbidity associated with traditional graft explantation and revascularization.