Autologous Superficial Femoral Vein for the Repair of Suprarenal Mycotic Aneurysms: A Preferred Conduit?

Abstract

The authors report a patient who presented with a ruptured mycotic aneurysm that destroyed the posterior segment of the suprarenal perimesenteric aorta. Initial in-line repair with a rifampin-soaked Dacron prosthetic patch failed 14 days postoperatively with recurrent hemorrhage. At reoperation, the aorta was repaired with a superficial femoral/popliteal vein interposition graft; a segment of superficial femoral/popliteal vein was also used in-line to revascularize the superior mesenteric and celiac arteries. The patient survived with no evidence of recurrence at 8 months postoperatively.

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References

1. Clagett GP , Valentine RJ , Hagino RT : Autogenous aortoiliac/femoral reconstruction from superficial femoral-popliteal veins: Feasibility and durability. J Vasc Surg 25:255-270, 1997.

2. Bitseff EL , Edwards WH , Mulherin JL , et al: Infected abdominal aortic aneurysms. S Med J 80:309-312, 1987.

3. James EC , Gillespie JT : Aortic mycotic abdominal aneurysm involving all visceral branches: Excision and Dacron graft replacement. J Cardiovasc Surg (Torino) 18:353-356, 1977.

4. Chan FY , Crawford ES , Coselli JS , et al: In situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann Thorac Surg 47:193-203, 1989.

5. Sailors DM , Eidt JF , Gagne PJ , et al: Primary clostridium septicum aortitis: A rare cause of necrotizing suprarenal aortic infection. A case report and review of the literature. J Vasc Surg 23:714-718, 1996.

6. Reddy DJ , Lee RE , Oh HK : Suprarenal mycotic aortic aneurysm: Surgical management and follow-up. J Vasc Surg 3:917-920, 1986.

7. Brown PM Jr , Kim VB , Lalikos JF , et al: Autologous superficial femoral vein for aortic reconstruction in infected fields. Ann Vasc Surg 13:32-36, 1999.

8. Hagino RT , Clagett GP , Valentine RJ : A case of Pott's disease of the spine eroding into the suprarenal aorta. J Vasc Surg 24:482-486, 1996.

9. Clagett GP , Bowers BL , Lopez-Viego MA , et al: Creation of a neo-aortoiliac system from lower extremity deep and superficial veins. Ann Surg 218:239-249, 1993.

10.

10. Palma JH , Gomes WJ , Almeida DR , et al: Replacement of infected thoracic aortic prosthesis with a spiral composite vein graft. Ann Thorac Surg 65:1135-1137, 1998.

11.

11. Nevelsteen A , Lacroix H , Suy R : Autogenous reconstruction with the lower extremity deep veins: An alternative treatment of prosthetic infection after reconstructive surgery for aortoiliac disease. J Vasc Surg 22:129-134, 1995.