| Combined endovascular and surgical treatment of infected carotid-carotid bypass graft. | |
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MedLine Citation:
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PMID: 17042656 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To present a complex case involving an infected carotid-carotid bypass graft that was successfully treated with a stent-graft and subsequent surgical removal of the infected graft. CASE REPORT: A 75-year-old woman presented with persistent purulent drainage of an infected and exposed carotid-carotid prosthetic bypass graft. Wound cultures revealed methicillin-resistant Staphylococcus aureus. She was treated with appropriate intravenous antibiotic therapy without improvement in wound drainage. Because of her comorbid conditions, a decision was made to pursue endovascular revascularization of her left and right common carotid arteries (CCA), with subsequent surgical removal of the infected prosthetic graft. The patient underwent balloon angioplasty; a 7x18-mm Omnilink stent was deployed in the innominate artery and a 7x18-mm Herculink stent in the ostial left CCA. During the same procedure, the carotid-carotid bypass graft was excluded with deployment of an 8x50-mm Viabahn stent-graft in the right CCA. Several days later, the infected and now thrombosed carotid-carotid bypass graft was surgically removed, and an area of adjacent muscle was used to patch the previously excluded connection of the bypass from the right CCA. A saphenous vein patch was used to repair the defect in the left CCA. Her postoperative course was uneventful. At 1 year, the clinical and duplex examinations revealed satisfactory wound healing and patent left and right CCAs. CONCLUSION: This case indicates that a combined endovascular and surgical approach may be a safe and effective option in the treatment of carotid-carotid bypass graft infection. |
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Authors:
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George Younis; George J Reul; Zvonimir Krajcer |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists Volume: 13 ISSN: 1526-6028 ISO Abbreviation: J. Endovasc. Ther. Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-10-17 Completed Date: 2007-02-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100896915 Medline TA: J Endovasc Ther Country: United States |
Other Details:
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Languages: eng Pagination: 687-92 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Texas Heart Institute, St. Luke's Hospital, Houston, TX 77030, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Balloon* Blood Vessel Prosthesis Implantation* / instrumentation Carotid Artery, Common / physiopathology, surgery* Carotid Stenosis / surgery* Combined Modality Therapy Endarterectomy, Carotid Fatal Outcome Female Humans Reoperation Saphenous Vein / surgery Staphylococcal Infections / complications, microbiology, surgery* Staphylococcus aureus Stents Surgical Wound Infection / etiology, surgery* Vascular Patency Wound Healing |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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