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Stent-Graft Placement with Early Debridement and Antibiotic Treatment for Femoral Pseudoaneurysms in Intravenous Drug Addicts

  • Clinical Investigation
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CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

Explore the application of endovascular covered stent-graft (SG) placement in femoral pseudoaneurysms in intravenous drug addicts.

Materials and Methods

We evaluated a consecutive series of pseudoaneurysm in intravenous drug addicts treated with SGs from August 2010 to December 2013.

Results

15 patients with 16 arterial pseudoaneurysms were enrolled in this study. All were males with a mean age of 36.9 years. Hemorrhage was the most common reason (93.8 %) for seeking medical care, and 3 of these patients were in hemorrhagic shock at admission. All patients received broad-spectrum antibiotics, and debridement and drainage were implemented after SG placement. 7 of the 13 cases which had microbiologic results showed mixed infections, while gram-negative bacteria were the major pathogens. Except for 2 patients, who were lost to follow-up, two new pseudoaneurysms formed due to delayed debridement, and one stent thrombosis occurred, none of the remaining cases had SG infection or developed claudication.

Conclusions

SG placement controls massive hemorrhage rapidly, gives enough time for subsequent treatment for pseudoaneurysms due to intravenous drug abuse, and reduces the incidence of postoperative claudication. With appropriate broad-spectrum antibiotics and early debridement, the incidence of SG infection is relatively low. It is an effective alternative especially as temporary bridge measure for critical patients. However, the high cost, uncertain long-term prospects, high demand for medical adherence, and the risk of using the conduits for re-puncture call for a cautious selection of patients. More evidence is required for the application of this treatment.

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Acknowledgments

The study was supported by National Key Clinical Specialties Construction Program of China.

Conflict of interest

The authors had full access to the data and take responsibility for its integrity, read and agree with the manuscript as written, and have no conflict of interest to declare.

Statement of informed consent

No informed consent was obtained for this article because data were analyzed retrospectively and anonymously.

Statement of human and animal rights

Ethical approval is not required for this retrospective study.

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Authors and Affiliations

  1. Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China

    Qining Fu, Xiyun Meng, Fenghe Li, Xuehu Wang, Jun Cheng, Wen Huang, Wei Ren & Yu Zhao

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  1. Qining Fu
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  2. Xiyun Meng
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  3. Fenghe Li
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  4. Xuehu Wang
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  5. Jun Cheng
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  6. Wen Huang
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  7. Wei Ren
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  8. Yu Zhao
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Correspondence to Qining Fu or Yu Zhao.

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Fu, Q., Meng, X., Li, F. et al. Stent-Graft Placement with Early Debridement and Antibiotic Treatment for Femoral Pseudoaneurysms in Intravenous Drug Addicts. Cardiovasc Intervent Radiol 38, 565–572 (2015). https://doi.org/10.1007/s00270-014-0994-y

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  • DOI: https://doi.org/10.1007/s00270-014-0994-y

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