Acute infection of Viabahn stent graft in the popliteal artery

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Acute infection of Viabahn stent graft in the popliteal artery S. Michael Gharacholou, MD, MSc, Marshall Dworak, Ala S. Dababneh, MD, Raj Varatharaj Palraj, MBBS, Michael C. Roskos, MD, Scott C. Chapman, MD Journal of Vascular Surgery Cases and Innovative Techniques Volume 3, Issue 2, Pages 69-73 (June 2017) DOI: 10.1016/j.jvscit.2017.02.003 Copyright © 2017 The Author(s) Terms and Conditions

Fig 1 A, Arterial ultrasound of right popliteal artery demonstrating complete short-segment occlusion and absence of flow. B, Computed tomography angiography reconstruction demonstrating bilateral short-segment occlusions of the popliteal artery. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 69-73DOI: (10.1016/j.jvscit.2017.02.003) Copyright © 2017 The Author(s) Terms and Conditions

Fig 2 A, Digital subtraction angiography demonstrates complete occlusion of the right popliteal artery. B, Acute angioplasty failure (residual diameter stenosis >75%) despite repeated, prolonged balloon inflations. C, Treatment with a 5- × 50-mm Viabahn stent graft with good angiographic result. Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 69-73DOI: (10.1016/j.jvscit.2017.02.003) Copyright © 2017 The Author(s) Terms and Conditions

Fig 3 The patient returned to the emergency department 3 days later with fever, leg pain, swelling, and evidence of atheromatous vs septic emboli of the right lower extremity (A). Because of ongoing bacteremia despite vancomycin and rifampin, the patient underwent stent removal; it was noted that the popliteal artery had been destroyed by the infection (B), with the stent graft clearly visible at exploration (arrow). Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 69-73DOI: (10.1016/j.jvscit.2017.02.003) Copyright © 2017 The Author(s) Terms and Conditions

Fig 4 The patient developed gangrene of the distal right toes from septic emboli (A) and required amputation of the toes on the right foot with subsequent healing of the surgical site (B). Journal of Vascular Surgery Cases and Innovative Techniques 2017 3, 69-73DOI: (10.1016/j.jvscit.2017.02.003) Copyright © 2017 The Author(s) Terms and Conditions