Arterial reconstruction for atypical mycotic aneurysms. Vasc Endovascular Surg 2013 Jan;47(1):45-7
Date
10/11/2012Pubmed ID
23047819DOI
10.1177/1538574412462636Scopus ID
2-s2.0-84872544468 (requires institutional sign-in at Scopus site)Abstract
Our case involves a 67-year-old man with a post lung transplantation status for idiopathic pulmonary fibrosis, who was initially referred to our institution for treatment of left hip septic arthritis due to Pseudallescheria boydii infection. One month following total hip arthroplasty, he noticed left upper thigh swelling with duplex imaging consistent with a 7-cm mid-superficial femoral artery aneurysm with popliteal vein compression and associated deep venous thrombosis. During operative resection, exploration of his contralateral saphenous vein showed inadequate conduit for use. Therefore, we proceeded with proximal and distal clamp control with intraoperative arterial shunting followed by cryoarterial reconstruction after complete aneurysm sac resection and debridement. Intraoperative arterial wall cultures remained negative for bacterial pathogens; however, final operative fungal cultures once again grew Pseudallescheria boydii. Our case highlights the complexity of adequate source control with effective arterial reconstruction in these immunosuppressed patient populations, particularly with fungal organisms that historically have poor therapeutic response to medical therapy alone.
Author List
Malinowski MJ, Halandras PAuthor
Michael Malinowski MD Associate Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Aneurysm, InfectedAntifungal Agents
Debridement
Femoral Artery
Humans
Male
Middle Aged
Mycoses
Pseudallescheria
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures
