Perigraft vascularization and incorporation of implanted Dacron prostheses are affected by rifampicin coating

The article presents a case of a hybrid intervention using an arterial allograft on the great arteries of the lower extremities in a patient with chronic limb threatening ischemia and prosthetic infection. The patient has a history of repeated operations using synthetic polytetrafluoroethylene and dacron prostheses. In the early postoperative period, a clinical presentation of the prosthesis bed suppuration developed. The article shows the main phases of patient treatment: removal of synthetic prostheses, transplantation of the donor femoral artery, and balloon angioplasty of the popliteal and anterolateral arteries. In the postoperative period, blood circulation in the lower limb is fully compensated, and the dorsal pedis artery pulse is determined. Wounds were healed by primary intention. At the control visit after 6 months, no adverse events were revealed; according to the data of duplex scanning, the main blood flow in the arteries of the leg was recorded, the blood circulation was fully compensated. Thus, hybrid intervention using arterial allograft and balloon angioplasty of the popliteal and anterolateral tibial arteries proved to be an effective method of treatment in the current clinical situation.

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Prosthetic Subclavian-Aortic Bypass as a Safe Surgical Technique for the Coarctation of the Aorta in Adults

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2016.006 ◽

2015 ◽

Vol 4 (1) ◽

pp. 47-49

Author(s):

Ali Refatllari ◽

Ermal Likaj ◽

Selman Dumani

Keyword(s):

Spinal Cord ◽

Congenital Heart ◽

Coarctation Of The Aorta ◽

Bypass Grafting ◽

Pressure Gradients ◽

Aortic Bypass ◽

Early Results ◽

The Mean ◽

Dacron Prostheses ◽

Spinal Cord Vascularization

BACKGROUND: Coarctation represents 5-8% of congenital heart disease. Residual hypertension remains the main problem after late correction. Surgical treatment in the adult remains a challenge for the surgeon. Our prefered method used in this category is the Subclavian-aortic bypass.MATERIAL AND METHODS: We have reviewed our registry for the period of 12 years (1998- 2010) and we found a group of 18 adult patients being operated for coarctation of the aorta. The mean age of this group of patients was 24.7 ± 8.43 years (range 16-42 years). 13 were males and 5 females. RESULTS: Sugical technique: Most of the patients (13 pts, 72%) which were obviously treated with subclavian-aortic bypass with a Dacron prostheses. Mean preoperative and postoperative pressure gradients measured by echocardiography were 77.7 ± 20.16 mmHg and 22.3 ± 9.14 mmHg respectively. No mortality was observed in this series of patients. Chylothorax was the only complication observed in one patient in the early postoperative period.CONCLUSION: Coarctation of the aorta in adults is treated with optimal early results at our surgical centre. Subclavian-aortic bypass grafting requires less aortic dissection, can be performed with a partially occluding clamp, and does not compromise the spinal cord vascularization.

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Urological complication following aortoiliac graft: case report and review of the literature

Sao Paulo Medical Journal ◽

10.1590/s1516-31802010000300010 ◽

2010 ◽

Vol 128 (3) ◽

pp. 174-176 ◽

Cited By ~ 3

Author(s):

Leonardo Lima Borges ◽

Fábio César Miranda Torricelli ◽

Gustavo Xavier Ebaid ◽

Antônio Marmo Lucon ◽

Miguel Srougi

Keyword(s):

Case Report ◽

Filling Defect ◽

Excretory Urography ◽

Lumbar Pain ◽

Crossing Over ◽

Ureteral Stenosis ◽

Excretory Urogram ◽

History Of ◽

Dacron Prostheses ◽

Segmental Ureterectomy

CONTEXT: Ureteral stenosis and ureterohydronephrosis may be serious complications of aortoiliac or aortofemoral reconstructive surgery. CASE REPORT: A 62-year-old female patient presented with a six-month history of left lumbar pain. She was a smoker, and had mild chronic arterial hypertension and Takayasu arteritis. She had previously undergone three vascular interventions. In two procedures, Dacron prostheses were necessary. Excretory urography showed moderate left ureterohydronephrosis and revealed a filling defect in the ureter close to where the iliac vessels cross. This finding was compatible with ureteral stenosis, and the aortoiliac graft may have been the reason for this inflammatory process. The patient underwent laparotomy, which showed that there was a relationship between the ureteral stenosis and the vascular prosthesis. Segmental ureterectomy and end-to-end ureteroplasty with the ureter crossing over the prosthesis anteriorly were performed. There were no complications. The early and late postoperative periods were uneventful. The patient evolved well and the results from a new excretory urogram were normal. We concluded that symptomatic ureterohydronephrosis following aortoiliac graft is a real complication and needs to be quickly diagnosed and treated by urologists.

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