In Situ Composite Homograft Utilizing the Femoral Vein and the Occluded Superficial Femoral Artery after Eversion Endarterectomy for the Management of an Iliofemoral Synthetic Graft Infection.

Aortic or iliac graft infection is a serious complication in vascular surgery, which carries significant risks for the patient's limb and life and requires complex treatment. We report a patient who presented sepsis due to a previous ilio(common iliac)-femoral(profunda femoris) graft infection. Taking into account that the superficial femoral and popliteal arteries were occluded (no suitable target vessel, except for the distal profunda femoral) and the fact that he presented methicillin-resistant Staphylococcus aureus-positive blood cultures, the patient was scheduled for excision of the contaminated graft and in situ reconstruction. Along with the femoral vein, a segment of the adjacent occluded superficial femoral artery was used after eversion endarterectomy to ensure adequate homograft length to perform the bypass. To our knowledge, this is the first report of this technique which can be particularly useful in similar settings.