Persistent mycotic superficial femoral artery pseudoaneurysm after endovascular treatment: a case report

J Vasc Bras . 2021 Sep 14;20:e20200095. doi: 10.1590/1677-5449.200095. eCollection 2021.

Fecha de la publicación: 14/09/2021

Autor: Ruth Fuente (1), Francisco J Medina (1), Natalia Moradillo (1), Ignacio Agúndez (1), Mónica Herrero (1), Victoria Santaolalla (1)

Palabras clave: Endovascular treatment, Escherichia coli; arterial ligation, Mycotic pseudoaneurysm, Stent thrombosis, Superficial femoral artery

PMID

Affiliations

1Burgos University Hospital, Vascular Surgery Department, Burgos, Spain.

Abstract

Mycotic pseudoaneurysms of the superficial femoral artery (SFA) are rare and are usually secondary to colonization of an atherosclerotic plaque during an episode of bacteremia. We describe the case of a 68 year-old diabetic male who presented to the Emergency Department with pyrexia and a painful expanding mass in the left thigh. He had a history of diarrhea and had been treated 16 days earlier for an SFA pseudoaneurysm that had been excluded with a covered stent with no adjunctive antibiotic therapy. Angio CT showed an abscess surrounding femoral vessels and stent thrombosis. Under general anesthesia, we performed extensive debridement, removal of the endovascular material, SFA ligation, and empirical antibiotic therapy. Blood and tissue cultures were positive for Escherichia coli. At the 3-months follow up visit, the patient reported he had no claudication. In selected patients, mycotic pseudoaneurysms can be treated by SFA ligation.