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HPI

HPI.

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HPI

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  1. HPI 69 yo female with hypertension, hyperlipidemia, hypothyroidism and PVD. Developed BLE claudication in 2007. Allergic to contrast. S/p Bilateral SFA stents (Viabahn) using CO2 angiography. Experienced L SFA stent occlusion and rest pain. Unsuccessful thrombolysis  s/p L femoral to below knee popliteal artery bypass with SVG (2 pieces). Postop with L thigh wound infection.

  2. HPI (cont) Began to have recurrent LLE claudication. Evaluated by duplex and found to have a 2.3x2.3 cm pseudoaneurysm in the mid thigh. MRA confirmed a 2.9 cm pseudoaneurysm in the left mid thigh. Duplex (5/08): elevated velocity of 517 cm/s in the area of the venovenous anastamosis and a narrowed vein graft segment distal to pseudoaneurysm.  ABI 0.56 (from 0.94 in 4/08)

  3. Operation: • Resection of SVG bypass pseudoaneurysm • Revision Femoral to Popliteal artery bypass with interposition vein graft Findings: 4x2 cm pseudoaneurysm

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