External Iliac–Superficial Femoral Artery Bypass Surgery for Intractable Common Femoral Artery Infection

Abstract

The common femoral artery is frequently used as a puncture site during catheterization or as an anastomosis site during revascularization. Therefore, although rare, infection can occur at this site and its treatment might be intractable. We experienced two cases of infection of the common femoral artery: the first after common femoral artery patch plasty for arteriosclerosis obliterans and the second following rupture of an infected pseudoaneurysm at the puncture site for percutaneous coronary intervention. In both cases, bleeding occurred, which required emergency surgery. However, the infected arterial wall was fragile, and reconstruction of the common femoral artery was impossible. In both cases, the femoral artery was sutured closed and revascularization was performed by external iliac–superficial femoral artery bypass surgery with a great saphenous vein graft. The graft was passed through the inguinal or lateral femoral subcutaneous tunnel, and not through the obturator foramen. Although wound dehiscence occurred in both cases, it healed with antibiotic therapy and wound care. External iliac–superficial femoral artery bypass is useful as an emergency surgery for femoral artery infection with bleeding.