Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202101911
Jornal Vascular Brasileiro
Case Report

Tratamento híbrido para revascularização de membro inferior em paciente com infecção de prótese vascular: relato de caso

Hybrid treatment for lower limb revascularization in a patient with vascular graft infection: a case report

Eduardo Lichtenfels; Nilon Erling Junior; Newton Roesch Aerts; Andre Silvestri Reitz da Costa

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Resumo

Resumo: Pacientes portadores de doença arterial obstrutiva periférica com isquemia crítica do membro associada a infecção de prótese vascular apresentam elevadas taxas morbimortalidade e alto risco de perda do membro. Apresentamos o caso de um paciente masculino de 76 anos com isquemia crítica do membro inferior esquerdo associada a infecção de prótese vascular femoropoplítea. Utilizamos abordagem híbrida para o tratamento com acesso cirúrgico das regiões inguinais e poplíteas, sendo a prótese vascular utilizada como acesso endovascular para recanalização direta da artéria femoral superficial devido a obstrução longa e extensa calcificação, que impediram as tentativas iniciais de tratamento endovascular. Após a recanalização endovascular, a prótese infectada foi retirada. O avanço das técnicas e materiais endovasculares em associação com a cirurgia aberta permitem novas soluções para pacientes quando os procedimentos habituais falham.

Palavras-chave

infecção de prótese, procedimentos endovasculares, salvamento de membro

Abstract

Patients with severe arterial obstructive disease and critical limb ischemia associated with vascular graft infection have elevated morbidity and mortality rates and are at high risk of limb loss. We present the case of a 76-year-old male patient with left lower limb critical ischemia and a femoropopliteal vascular graft infection. We used a hybrid treatment approach with an open surgical approach to the inguinal and popliteal regions and used the vascular prosthesis as endovascular access for direct recanalization of the superficial femoral artery, because the long occlusion and extensive calcification had frustrated initial attempts at endovascular treatment. After endovascular recanalization, the infected graft was removed. Used in conjunction with open surgery, advances in endovascular techniques and materials offer new solutions for patients when usual procedures fail.

Keywords

prosthesis-related infection; endovascular procedures; limb salvage.

References

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Submitted date:
10/13/2021

Accepted date:
02/21/2022

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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