Methodist Journal

IN THIS ISSUE

Venous Interventions

Vol 14, Issue 3 (2018)


FEATURED GUEST EDITOR

ISSUE INTRO

It’s Time We Reassess Our Primitive Understanding of the Venous System

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RECOGNITIONS

Jean Bismuth Spearheads Issue on Venous Interventions

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REVIEW ARTICLES See More

Central Venous Pathologies: Treatments and Economic Impact

Venous Thrombosis and Post-Thrombotic Syndrome: From Novel Biomarkers to Biology

Mechanical Properties of Diseased Veins

Use of Computed Tomography and Magnetic Resonance Imaging in Central Venous Disease

Application of Intravascular Ultrasound in End-Stage Renal Patients with Central Venous Occlusive Disease

Intraoperative Imaging and Image Fusion for Venous Interventions

Endovascular Treatment for Venous Diseases: Where are the Venous Stents?

Endovascular Therapy for Central Venous Thrombosis

CASE REPORTS See More

Immune Checkpoint Inhibitor Related Cardiotoxicity

Tyrosine Kinase Inhibitor-Induced Acute Myocarditis, Myositis, and Cardiogenic Shock

Primary Nonbacterial Thrombotic Endocarditis Presenting with Bowel Infarction Secondary to Superior Mesenteric Artery Embolism

Persistent Left Superior Vena Cava with Absent Right Superior Vena Cava

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Incision and Drainage of a Forgotten Vascular Graft

CLINICAL PERSPECTIVES See More

EXCERPTA

Telemedicine Shakes Up the ICU Experience

POINTS TO REMEMBER

Venous Thrombosis in Nephrotic Syndrome

EXCERPTA

Heartsick: Medical and Ethical Challenges of Infective Endocarditis in the Opioid Epidemic

EXCERPTA

Redefining “Worth It” for CTO PCI

EDITORIALS

Letter to the Editor

Vol 14, Issue 3 (2018)

Article Full Text

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER

Incision and Drainage of a Forgotten Vascular Graft

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Article Citation:

DaSilva-DeAbreu A, Hsi B. Incision and Drainage of a Forgotten Vascular Graft. Methodist DeBakey Cardiovasc J. 2018;14(3):236.



Keywords
femoral-popliteal bypass , vascular graft

A 64-year-old woman with type-2 diabetes mellitus, peripheral artery disease with bilateral below-knee amputation, and recurrent soft tissue infections on her right thigh presented with a 5-day history of an abscess on the posterior side of her right thigh (Panel A). She was prescribed oral clindamycin followed by incision and drainage the next day, which revealed a vascular graft that protruded at about 20 cm from the draining site without any sign of bleeding (Panel B; in both panels, the patient is lying down with the right knee elevated).

She had undergone a femoral-popliteal bypass 2 years prior to presentation followed by ilio-peroneal bypass and excision of the former. She had right below-knee amputation 2 months later but continued having recurrent soft tissue infections on the right thigh associated with poorly controlled diabetes and a hemoglobin A1c of up to 18.5.

The patient was admitted to the hospital, where she received broad-spectrum antibiotics and underwent surgical exploration of the right groin. The femoral artery was located without evidence of graft anastomosis. The graft was retrieved from the superficial free end on the posterior aspect of the thigh. The wound tract was irrigated, obtaining notable purulent drainage. Wound cultures grew Pseudomonas aeruginosa, for which she received meropenem. She progressed uneventfully and was discharged home.

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