title: Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin.
abstract: A 78-year-old man presented with a 7-cm aneurysm in the left superficial femoral artery, which was considered unfit and anatomically unsuitable for conventional open surgery for multiple comorbidities. The patient was treated with stent-graft [Viabhan stent-graft (WL Gore and Associates, Flagstaff, AZ)]. Two years from stent-graft implantation, the patient presented a purulent secretion and a spontaneous external expulsion through a fistulous channel. No claudication symptoms or hemorrhagic signs were present. The pus and device cultures were positive for Staphylococcus aureus sensitive to piperacillin/tazobactam. Patient management consisted of fistula drainage, systemic antibiotic therapy, and daily wound dressing. At 1-month follow-up, the wound was closed. To our knowledge, this is the first case of this type of stent-graft complication presenting with external expulsion.
authors.affiliation: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone" Via Liborio Giuffrè 5, Palermo, Italy. felicepecoraro@libero.it.
authors.forename: Felice
authors.initials: F
authors.lastname: Pecoraro
authors.affiliation: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone" Via Liborio Giuffrè 5, Palermo, Italy.
authors.forename: Ermanno R
authors.initials: ER
authors.lastname: Sabatino
authors.affiliation: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone" Via Liborio Giuffrè 5, Palermo, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Dinoto
authors.affiliation: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone" Via Liborio Giuffrè 5, Palermo, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: La Rosa
authors.affiliation: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone" Via Liborio Giuffrè 5, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Corte
authors.affiliation: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone" Via Liborio Giuffrè 5, Palermo, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Bajardi
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000150:complications / Q000601:surgery*; D005263:Femoral Artery / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D013203:Staphylococcal Infections / Q000150:complications*; D013211:Staphylococcus aureus; D015607:Stents
keywords: Aneurysm; Endovascular; Infection; Stent-graft; Superficial femoral artery