CardioVascular and Interventional Radiology

, Volume 30, Issue 6, pp 1238–1241 | Cite as

Emergency Stenting of a Ruptured Infected Anastomotic Femoral Pseudoaneurysm

  • Chris KlonarisEmail author
  • Athanasios Katsargyris
  • Alexandros Matthaiou
  • Athanasios Giannopoulos
  • Chris Tsigris
  • Katerina Papadopouli
  • Sotiris Tsiodras
  • Elias Bastounis
Case Report


A 74-year-old man presented with a ruptured infected anastomotic femoral pseudoaneurysm. Due to severe medical comorbidities he was considered unsuitable for conventional surgical management and underwent an emergency endovascular repair with a balloon-expandable covered stent. The pseudoaneurysm was excluded successfully and the patient had an uneventful postoperative recovery with long-term suppressive antimicrobials. He remained well for 10 months after the procedure with no signs of recurrent local or systemic infection and finally died from an acute myocardial infarction. To our knowledge, emergency endovascular treatment of a free ruptured bleeding femoral artery pseudoaneurysm has not been documented before in the English literature. This case illustrates that endovascular therapy may be a safe and efficient alternative in the emergent management of ruptured infected anastomotic femoral artery pseudoaneurysms when traditional open surgery is contraindicated.


Emergency stenting Femoral pseudoaneurysm Infection Rupture 


  1. 1.
    Demarche M, Waltregny D, van Damme H, et al. (1999) Femoral anastomotic aneurysms: Pathogenic factors, clinical presentations and treatment. A study of 142 cases. Cardiovasc Surg 7:315–322PubMedCrossRefGoogle Scholar
  2. 2.
    Brountzos EN, Malagari K, Gougoulakis A, et al. (2000) Common femoral artery anastomotic pseudoaneurysm: Endovascular treatment with Hemobahn stent-grafts. J Vasc Interv Radiol 11:1179–1183PubMedCrossRefGoogle Scholar
  3. 3.
    Baril DT, Ellozy SH, Carroccio A, et al. (2004) Endovascular repair of an infected carotid artery pseudoaneurysm. J Vasc Surg 40:1024–1027PubMedCrossRefGoogle Scholar
  4. 4.
    Sanada J, Matsui O, Arakawa F, et al. (2005) Endovascular stent-grafting for infected iliac artery pseudoaneurysms. Cardiovasc Intervent Radiol 28:83–86PubMedCrossRefGoogle Scholar
  5. 5.
    van den Akker PJ, Brand R, van Schilfgaarde R, et al. (1989) False aneurysms after prosthetic reconstructions for aortoiliac obstructive disease. Ann Surg 210:658–666PubMedCrossRefGoogle Scholar
  6. 6.
    Derom A, Marcoen S, Vermassen F, et al. (2001) Treatment of ruptured anastomotic aneurysm by endograft. J Cardiovasc Surg (Torino) 42:97–99Google Scholar
  7. 7.
    Seabrook GR, Schmitt DD, Bandyk DF, et al. (1990) Anastomotic femoral pseudoaneurysm: An investigation of occult infection as an etiologic factor. J Vasc Surg 11:629–634PubMedCrossRefGoogle Scholar
  8. 8.
    Ting AC, Cheng SW, Ho P, et al. (2006) Endovascular stent graft repair for infected thoracic aortic pseudoaneurysms: A durable option? J Vasc Surg 44:701–705PubMedCrossRefGoogle Scholar
  9. 9.
    Kwon K, Choi D, Choi SH, et al. (2002) Percutaneous stent-graft repair of mycotic common femoral artery aneurysm. J Endovasc Ther 9:690–693PubMedCrossRefGoogle Scholar
  10. 10.
    Clarke MG, Thomas HG, Chester JF (2005) MRSA-infected external iliac artery pseudoaneurysm treated with endovascular stenting. Cardiovasc Intervent Radiol 28:364–366PubMedCrossRefGoogle Scholar
  11. 11.
    Therasse E, Soulez G, Cartier P, et al. (1994) Infection with fatal outcome after endovascular metallic stent placement. Radiology 192:363–365PubMedGoogle Scholar
  12. 12.
    Benjamin ME, Cohn EJ Jr, Purtill WA, et al. (1999) Arterial reconstruction with deep leg veins for the treatment of mycotic aneurysms. J Vasc Surg 30:1004–1015PubMedCrossRefGoogle Scholar
  13. 13.
    Kurimoto Y, Tsuchida Y, Saito J, et al. (2003) Emergency endovascular stent-grafting for infected pseudoaneurysm of brachial artery. Infection 31:186–188PubMedGoogle Scholar
  14. 14.
    Bergamini TM, Bandyk DF, Govostis D, et al. (1988) Infection of vascular prostheses caused by bacterial biofilms. J Vasc Surg 7:21–30PubMedCrossRefGoogle Scholar
  15. 15.
    Edmiston CE Jr, Goheen MP, Seabrook GR, et al. (2006) Impact of selective antimicrobial agents on staphylococcal adherence to biomedical devices. Am J Surg 192:344–354PubMedCrossRefGoogle Scholar
  16. 16.
    Stricker H, Jacomella V (2004) Stent-assisted angioplasty at the level of the common femoral artery bifurcation: Midterm outcomes. J Endovasc Ther 11:281–286PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Chris Klonaris
    • 1
    • 3
    Email author
  • Athanasios Katsargyris
    • 1
  • Alexandros Matthaiou
    • 1
  • Athanasios Giannopoulos
    • 1
  • Chris Tsigris
    • 1
  • Katerina Papadopouli
    • 1
  • Sotiris Tsiodras
    • 2
  • Elias Bastounis
    • 1
  1. 1.1st Department of Surgery, Vascular Division“LAIKON” Hospital, Athens University Medical SchoolAthensGreece
  2. 2.4th Academic Department of Internal MedicineAttikon Hospital, Athens University Medical SchoolAthensGreece
  3. 3.PsihicoGreece

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