Neo-Femoral Artery Reconstruction with Autologous Bifurcated Great Saphenous Vein Graft in an 88-Year-Old Patient with a Large Infected Pseudoaneurysm

Szanto, Ludovic-Alexandru; Ujlaki-Nagy, Alexandru-Andrei; Russu, Eliza; Arbănași, Emil-Marian

doi:10.2478/jce-2025-0015

Abstract

We present the case of an 88-year-old patient with multiple cardiovascular comorbidities who, on the first day after transcatheter aortic valve implantation (TAVI), developed sudden severe pain in the right lower extremity. Urgent computed tomography angiography (CTA) of the abdominal aorta and lower limbs revealed a patent right common iliac artery with thrombotic occlusion of the external iliac and femoral arteries. A transfemoral thromboembolectomy using a Fogarty catheter was performed at the iliofemoral axis, supplemented by local endarterectomy and patch angioplasty. Over the following three weeks, two additional interventions were required to evacuate an inguinal hematoma and secure hemostasis at the patch level. Three months later, the patient returned to the emergency department with severe groin pain and active bleeding from the wound. CTA revealed a large infected pseudoaneurysm of the common femoral artery, measuring approximately 4 × 2.5 cm. Reconstruction of the neo-femoral artery was carried out using an autologous bifurcated great saphenous vein graft, combined with a proximal sartorius muscle flap. At six months, CTA demonstrated patent femoral arteries without thrombus or hematoma and complete tissue healing.

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Neo-Femoral Artery Reconstruction with Autologous Bifurcated Great Saphenous Vein Graft in an 88-Year-Old Patient with a Large Infected Pseudoaneurysm

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