Asad Mehmud Malik, Muhammad Naeem Ashraf, Shahbaz Bakht Kayani.
Experience of treating Mycotic Aneurysm of femoral artery at Foundation University Medical College Hospital, Rawalpindi.
Pak Armed Forces Med J Jan ;57(3):243-5.

A forty eight years old male, presented with pain and large swelling in the right groin and patches of discoloration over the right leg for three weeks. Patient presented with above complaints to a private medical center and underwent thrombectomy of femoral vein. Post operatively pain, and swelling increased causing pressure necrosis of the overlying skin. With worsening pain and discoloration of right leg, patient was referred for vascular intervention. The limb was in critical ischemia. Diagnosis of bleeding mycotic aneurysm was made and emergency by pass surgery was done with 8mm PTFE vascular graft between external iliac artery and right femoral artery in mid thigh. The proximal and distal ends of aneurysm were ligated to control the bleeding. Intervening segment was literally absent. Groin wound was covered with myocutaneous flap of tensor fascia lata. Empiric antibiotic coverage was provided. On fifth day, there was bleeding from the proximal anastomosis. The graft was explored and proximal anastomosis was refashioned. The graft was covered with local muscle and skin flap. After three weeks there was recurrence of bleeding. Probably due to graft failure secondary to infection.This time 10 mm Dacron vascular graft was anastomosed with origin of right External iliac artery and brought into thigh by making a tunnel just medial to anterior superior iliac spine through quadriceps muscle and anastomosed with healthy right femoral artery just above the adductor hiatus.

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