Ruptured mycotic common femoral artery pseudoaneurysm: fatal pulmonary embolism after emergency stent-grafting in a drug abuser

Tex Heart Inst J. 2014 Dec 1;41(6):634-7. doi: 10.14503/THIJ-13-3882. eCollection 2014 Dec.

Abstract

The rupture of a mycotic femoral artery pseudoaneurysm in an intravenous drug abuser is a limb- and life-threatening condition that necessitates emergency intervention. Emergency stent-grafting appears to be a viable, minimally invasive alternative, or a bridge, to subsequent open surgery. Caution is required in cases of suspected concomitant deep vein thrombosis in order to minimize the possibility of massive pulmonary embolism during stent-grafting, perhaps by omitting stent-graft postdilation or by inserting an inferior vena cava filter first. We describe the emergency endovascular management, in a 60-year-old male intravenous drug abuser, of a ruptured mycotic femoral artery pseudoaneurysm, which was complicated by a fatal pulmonary embolism.

Keywords: Aneurysm, false; aneurysm, infected/surgery; aneurysm, ruptured; blood vessel prosthesis implantation; combined modality therapy; debridement; disease management; endovascular repair; femoral artery/surgery; mycosis; sequelae; substance abuse, intravenous/complications.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False / diagnosis
  • Aneurysm, False / microbiology
  • Aneurysm, False / surgery*
  • Aneurysm, Infected / diagnosis
  • Aneurysm, Infected / microbiology
  • Aneurysm, Infected / surgery*
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / microbiology
  • Aneurysm, Ruptured / surgery*
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Drug Users*
  • Emergencies
  • Endovascular Procedures / adverse effects*
  • Fatal Outcome
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / microbiology
  • Femoral Artery / surgery*
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / etiology*
  • Radiography, Interventional
  • Substance Abuse, Intravenous / complications*