Explantation of infected aortic aneurysm and endograft with ascending aorta to mesenteric bypass for mesenteric ischemia

Lindsay Gates; Jason A Chin; Pramod N Bonde; Cassius I Ochoa Chaar; Bauer E Sumpio; Timur P Sarac

doi:10.1016/j.jvs.2016.03.411

Explantation of infected aortic aneurysm and endograft with ascending aorta to mesenteric bypass for mesenteric ischemia

J Vasc Surg. 2017 Jan;65(1):219-223. doi: 10.1016/j.jvs.2016.03.411. Epub 2016 May 13.

Authors

Lindsay Gates¹, Jason A Chin¹, Pramod N Bonde², Cassius I Ochoa Chaar¹, Bauer E Sumpio¹, Timur P Sarac³

Affiliations

¹ Section of Vascular Surgery, Yale University School of Medicine, New Haven, Conn.
² Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Conn.
³ Section of Vascular Surgery, Yale University School of Medicine, New Haven, Conn. Electronic address: timur.sarac@yale.edu.

PMID: 27183855
DOI: 10.1016/j.jvs.2016.03.411

Abstract

A 65-year-old man presented with an infected perivisceral aortic aneurysm after previous treatment of an abdominal aortic aneurysm with an endograft. On presentation, he was septic and had occlusion of the celiac, superior mesenteric, inferior mesenteric, and bilateral renal arteries. He underwent a three-stage procedure: first, axillobifemoral bypass; then resection of the thoracoabdominal aorta; and finally bypass from the ascending aorta to the celiac and superior mesenteric arteries with a rifampin-soaked Gelsoft graft (Vascutek, Renfrewshire, Scotland). The abdominal pain resolved, and the patient remains symptom free 10 months postoperatively. This rare surgical revascularization technique offered a nontraditional solution to a difficult surgical issue.

Publication types

Case Reports

MeSH terms

Aged
Aneurysm, Infected / diagnostic imaging
Aneurysm, Infected / microbiology
Aneurysm, Infected / physiopathology
Aneurysm, Infected / surgery*
Anti-Bacterial Agents / administration & dosage
Aortic Aneurysm, Abdominal / diagnostic imaging
Aortic Aneurysm, Abdominal / physiopathology
Aortic Aneurysm, Abdominal / surgery*
Aortography / methods
Blood Vessel Prosthesis / adverse effects*
Blood Vessel Prosthesis Implantation / adverse effects*
Blood Vessel Prosthesis Implantation / instrumentation*
Celiac Artery / physiopathology
Celiac Artery / surgery
Coated Materials, Biocompatible
Collateral Circulation
Computed Tomography Angiography
Device Removal / methods*
Endovascular Procedures / adverse effects*
Endovascular Procedures / instrumentation*
Hepatic Artery / physiopathology
Hepatic Artery / surgery
Humans
Male
Mesenteric Artery, Superior / physiopathology
Mesenteric Artery, Superior / surgery
Mesenteric Ischemia / diagnostic imaging
Mesenteric Ischemia / microbiology
Mesenteric Ischemia / physiopathology
Mesenteric Ischemia / surgery*
Mesenteric Vascular Occlusion / diagnostic imaging
Mesenteric Vascular Occlusion / microbiology
Mesenteric Vascular Occlusion / physiopathology
Mesenteric Vascular Occlusion / surgery*
Prosthesis-Related Infections / diagnostic imaging
Prosthesis-Related Infections / microbiology
Prosthesis-Related Infections / physiopathology
Prosthesis-Related Infections / surgery*
Reoperation
Rifampin / administration & dosage
Splanchnic Circulation
Treatment Outcome

Substances

Anti-Bacterial Agents
Coated Materials, Biocompatible
Rifampin