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Infectious arteritis of the femoral artery as a cause of recurrent hemorrhage after endovascular treatment of thrombosed popliteal artery aneurysm.
, 1
Affiliations- First Department of General and Vascular Surgery, Faculty of Medicine, Medical University of Warsaw, Kondratowicza 8, 03-242 Warsaw, Poland
open access
Abstract
Due to a great number of endovascular interventions, conducted over the last decades, a huge percentage of obese patients and administration of double antiplatelet therapy, manual compression (MC) is more and more frequently replaced by a vascular closure device of which the most common is Angio-Seal. The study presents a case of a 63-year old female patient with recurrent hemorrhages of the common femoral artery (CFA), originally closed after an endovascular intervention of a popliteal artery aneurysm with the use of Angio-Seal VIP. After around 3 weeks following the original surgery, the patient at first developed a pseudoaneurysm and then septic inflammation of the femoral artery, manifested with recurrent hemorrhages from the groin. The patient was operated on many times and an implantation of an ilio-femoral bypass from the femoral vein turned out to be an effective solution. Staphylococcus epidermidis MRSA was cultured in the femoral artery wall and a histopathological examination confirmed infectious arteritis. The presented case of a rare septic complication after the application of a closure device shows that it is essential to carefully monitor surgical approach areas in patients who are quickly discharged from hospital after surgical interventions, to select treatment methods tailored for individual patients as well as implement particular surgical management.
Abstract
Due to a great number of endovascular interventions, conducted over the last decades, a huge percentage of obese patients and administration of double antiplatelet therapy, manual compression (MC) is more and more frequently replaced by a vascular closure device of which the most common is Angio-Seal. The study presents a case of a 63-year old female patient with recurrent hemorrhages of the common femoral artery (CFA), originally closed after an endovascular intervention of a popliteal artery aneurysm with the use of Angio-Seal VIP. After around 3 weeks following the original surgery, the patient at first developed a pseudoaneurysm and then septic inflammation of the femoral artery, manifested with recurrent hemorrhages from the groin. The patient was operated on many times and an implantation of an ilio-femoral bypass from the femoral vein turned out to be an effective solution. Staphylococcus epidermidis MRSA was cultured in the femoral artery wall and a histopathological examination confirmed infectious arteritis. The presented case of a rare septic complication after the application of a closure device shows that it is essential to carefully monitor surgical approach areas in patients who are quickly discharged from hospital after surgical interventions, to select treatment methods tailored for individual patients as well as implement particular surgical management.
Keywords
Angio-Seal, infectious complications, pseudoaneurysm, vascular closure device, popliteal artery aneurysm
About this articleTitle
Infectious arteritis of the femoral artery as a cause of recurrent hemorrhage after endovascular treatment of thrombosed popliteal artery aneurysm.
Journal
Issue
Article type
Case report
Pages
113-117
Published online
2021-01-07
Page views
513
Article views/downloads
548
DOI
Bibliographic record
Acta Angiologica 2020;26(3):113-117.
Keywords
Angio-Seal
infectious complications
pseudoaneurysm
vascular closure device
popliteal artery aneurysm
Authors
Witold Woźniak
Piotr Ciostek
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