Cadaveric allograft implantation to maintain limb viability in a case of traumatic pseudoaneurysm and poor native vessels

• Published in: Annals of the Royal College of Surgeons of England 2019-09, Vol.101 (7), p.e154-e156
• Main Authors: Wall, Jjs, Waduud, M A, Scott, Dja
• Format: Article
• Language: English
• Subjects: Adult; Allografts - transplantation; Aneurysm, False - diagnosis; Aneurysm, False - etiology; Aneurysm, False - microbiology; Aneurysm, False - surgery; Blood clots; Cadaver; Computed Tomography Angiography; Drug use; Femoral Artery - surgery; Femoral Vein - diagnostic imaging; Femoral Vein - injuries; Femoral Vein - microbiology; Femoral Vein - transplantation; Groin; Humans; Lower Extremity - blood supply; Male; Online Case Report; Phlebotomy - adverse effects; Staphylococcal Infections - diagnosis; Staphylococcal Infections - etiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - surgery; Staphylococcus aureus - isolation & purification; Surveillance; Thrombosis; Trauma; Treatment Outcome; Ultrasonic imaging; Vascular Grafting - methods; Vascular surgery; Veins & arteries
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/rcsann.2019.0080

Infected pseudoaneurysms are a vascular emergency, necessitating urgent surgical management. Owing to the infected field, a synthetic graft may be inappropriate in patients for whom autografting is impossible. Ligation of the artery is the usual management, often leading to amputation. We report a case of cadaveric allografting of the common femoral artery in a patient with a traumatic, infected pseudoaneurysm, who was taking immunosuppressive therapy for a liver transplant. The patient was followed up with ultrasound at 12 months and was found to have a significant graft stenosis, which was treated successfully with angioplasty. At 18 months, the patient remained well. This case describes the successful implantation of a cadaveric allograft into a patient with an infected pseudoaneurysm, negating the for need primary ligation.