Management of a Complicated Ruptured Infected Pseudoaneurysm of the Femoral Artery in a Drug Addict

Infected pseudoaneurysm of the femoral artery represents a devastating complication of intravenous drug abuse, especially in the event of rupture. Operative strategy depends upon the extent of arterial injury and the coexistence of infection or sepsis. Options range from simple common femoral artery (CFA) ligation to complex arterial reconstruction with autologous grafts (arterial, venous, or homografts). We report herein the management of a 29-year-old male patient who was urgently admitted with a ruptured pseudoaneurysm of the right CFA, extending well above the inguinal ligament. Multidisciplinary approach with multiple arterial reconstructions and subsequent coverage of the tissue defect with a rectus abdominis musculocutaneous flap transposition was performed.

[1]  J. Coffey,et al.  The management of mycotic femoral pseudoaneurysms in intravenous drug abusers. , 2009, Annals of vascular surgery.

[2]  C. Liapis,et al.  Hybrid repair of ruptured infected anastomotic femoral pseudoaneurysms: Emergent stent-graft implantation and secondary surgical debridement. , 2009, Journal of vascular surgery.

[3]  J. R. Schneider,et al.  Superficial femoral vein graft interposition in situ repair for femoral mycotic aneurysm. , 2009, Annals of vascular surgery.

[4]  P. Khashayar,et al.  Management of infected femoral pseudoaneurysms in intravenous drug abusers: a review of 57 cases. , 2008, Archives of medical research.

[5]  K. Tiesenhausen,et al.  Endovascular Treatment of Mycotic Aortic Pseudoaneurysms with Stent-Grafts , 2008, CardioVascular and Interventional Radiology.

[6]  C. Tsigris,et al.  Emergency Stenting of a Ruptured Infected Anastomotic Femoral Pseudoaneurysm , 2007, CardioVascular and Interventional Radiology.

[7]  G. Vourliotakis,et al.  Infected femoral artery pseudoaneurysm in drug addicts: the beneficial use of the internal iliac artery for arterial reconstruction. , 2007, Journal of vascular surgery.

[8]  P. Coughlin,et al.  Arterial consequences of recreational drug use. , 2006, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[9]  C. Simopoulos,et al.  Surgical treatment of femoral artery infected false aneurysms in drug abusers , 2005, ANZ journal of surgery.

[10]  D. Kessel,et al.  Endovascular treatment of a MRSA infected left external iliac artery pseudoaneurysm. , 2004, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.