Surgical Management of an infected external iliac artery interposition graft with a bioengineered human acellular vessel

ABSTRACT Infection of prosthetic vascular grafts can manifest as pain, pseudoaneurysms, or arterial insufficiency in the leg. We present the case of a female patient with a medical history of a right external iliac artery endofibrosis, with a persistently infected synthetic iliofemoral bypass graft, replaced with a bioengineered human acellular vessel. At the 12-month post-implantation visit, clinical and radiological studies demonstrated adequate human acellular vessel patency, with no signs of infection, stenosis, or pseudoaneurysm. Subsequent to the initiation of hormone therapy and cessation of anti-platelet therapy, the patient suffered graft thrombosis. She continues to do well after restoration of patency with lytic therapy. At 22 months, secondary patency is maintained with continued anticoagulation and the patient remains asymptomatic.