title: A novel hybrid device for avoiding redo surgery in synchronous iliac and femoral peri-anastomotic pseudo-aneurysms.
abstract: 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.
authors.affiliation: Department of Vascular Surgery, Westmead Hospital, Westmead, New South Wales, Australia. ramonvarcoe@yahoo.com
authors.forename: Ramon L
authors.initials: RL
authors.lastname: Varcoe
authors.forename: Dasantha
authors.initials: D
authors.lastname: Jayamanne
authors.forename: Alok
authors.initials: A
authors.lastname: Tiwari
authors.forename: John
authors.initials: J
authors.lastname: Swinnen
mesh_terms: 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
chemical_list: D003029:Coagulants; D013917:Thrombin