Arterial reconstruction for atypical mycotic aneurysms Journal Article

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Authors: Malinowski, M. J.; Halandras, P
Article Title: Arterial reconstruction for atypical mycotic aneurysms
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.
Journal Title: Vascular and endovascular surgery
Volume: 47
Issue: 1
ISSN: 1938-9116; 1538-5744
Publisher: Unknown  
Journal Place: United States
Date Published: 2013
Start Page: 45
End Page: 47
Language: eng
DOI/URL:

10.1177/1538574412462636

10.1177/1538574412462636
Notes: ID: 13162; JID: 101136421; 2012/10/08 [aheadofprint]; ppublish