A 73-year-old man presented with a draining abscess in the right groin five years after placement of an aortofemoral bypass graft . Dark yellow pus was expressed from a small sinus near the center of the abscess. Cultures grew S. aureus. CT scan demonstrated fluid surrounding both limbs of the AFB graft, confirming that the entire graft was infected.
The patient had severe claudication symptoms in the left leg and early rest pain in the right foot. Angiography revealed that the right limb of the AFB was occluded and there was an advanced stenosis at the left femoral anastomosis, which supplied a patent profunda femoris artery.
The decision was made to treat the graft infection by removing all prosthetic material and performing direct revascularization of the legs using autogenous tissue. Preoperative studies included venous duplex ultrasonography, which documented patency of the superficial femoral and popliteal veins (SFPV) in both legs. There were no duplications, stenoses, or chronic changes suggestive of old DVT.
Link to this frame from your Personal Thumbnails page?