title: Hybrid approach to limb salvage in the setting of an infected femoral-femoral bypass graft.
abstract: Prosthetic vascular graft infection in patients with advanced peripheral arterial disease can lead to multiple additional procedures, including extra-anatomic bypass or even amputation. We report the case of an 88-year-old woman with critical limb ischemia and an infected prosthetic femoral-femoral bypass graft. Using a planned hybrid 2-stage approach, we performed endovascular recanalization of the native left iliac arterial system using remote access via the superficial femoral artery to avoid infected groin wounds. Recanalization of the patient's Trans-Atlantic Inter-Society Consensus II D chronic iliac occlusion allowed for removal of the infected graft and placement of a profunda femoris artery to proximal posterior tibial artery bypass, thereby restoring inflow and avoiding the infected left groin. Newer endovascular techniques coupled with open surgical options may lead to limb salvage in patients with previously unreconstructable peripheral arterial disease.
authors: Department of Vascular and Endovascular Surgery, New York Presbyterian Hospital, Weill-Cornell Medical Center, New York, NY. Electronic address: Doj9016@nyp.org.
authors: Douglas W
authors: DW
authors: Jones
authors: Department of Vascular and Endovascular Surgery, New York Presbyterian Hospital, Weill-Cornell Medical Center, New York, NY.
authors: Andrew J
authors: AJ
authors: Meltzer
authors: Department of Vascular and Endovascular Surgery, New York Presbyterian Hospital, Weill-Cornell Medical Center, New York, NY.
authors: Darren B
authors: DB
authors: Schneider
mesh_terms: D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D016638:Critical Illness; D020878:Device Removal; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000601:surgery*; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012501:Saphenous Vein / Q000637:transplantation; D016038:Skin Transplantation; D015607:Stents / Q000009:adverse effects*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents