A novel hybrid device for avoiding redo surgery in synchronous iliac and femoral peri-anastomotic pseudo-aneurysms.
Synchronous peri-anastomotic pseudo-aneurysms were discovered in a 65-year-old man 26 years after an aorto-bi-iliac bypass and 11 years after an ileo-femoral bypass. He was a poor surgical candidate owing to his obesity, hostile abdomen, and multiple medical comorbidities. Therefore, a novel hybrid device was designed that was part stent graft with the addition of two 6-mm Dacron limbs for anastomosis onto the superficial femoral and profunda femoris arteries. An unexpected type 2 endoleak developed through the internal iliac artery, which was thought to be occluded. This was successfully treated with a direct injection of bovine thrombin. This was an excellent outcome, and the patient made an uneventful recovery.
Varcoe
Ramon L
RL
Department of Vascular Surgery, Westmead Hospital, Westmead, New South Wales, Australia. ramonvarcoe@yahoo.com
Jayamanne
Dasantha
D
Tiwari
Alok
A
Swinnen
John
J
D000368:Aged; D000714:Anastomosis, Surgical; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D001018:Aortic Diseases / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D003029:Coagulants / Q000008:administration & dosage; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015607:Stents; D013917:Thrombin / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
D003029:Coagulants; D013917:Thrombin