Biodegradation of a PTFE prosthesis

Processes of biodegradation of PTFE--as they were not seen before for this type of graft--are demonstrated by clinical examples. As it is possible to subsume these results to regularly described processes of incorporation of alloplastic material, it is to be expected that there will be more cases than those observed by us up to now.     

The early results of reconstruction of the femoral artery with a Gore-Tex prosthesis.

An analysis is presented of the results of forty-one reconstructions of the superficial femoral artery using a Gore-Tex prosthesis. There were four complications and the results, when the boundary conditions were good, were comparable to those obtained from reconstruction with autogenous vein. Most failures occurred in patients in whom the branches of the popliteal artery were obliterated. We concluded that a Gore-Tex prosthesis is a reasonable alternative when autogenous vein is unavailable, but it is overly optimistic to expect any prosthesis to work in circumstances where a vein is unlikely to work.     

Fracture of semirigid penile prosthesis: a rare complication

We report 3 cases of fractured semirigid Small-Carrion and Finney penile prostheses. All prostheses had been in place and functional for at least 2 years before fracture. We may begin to see more complications associated with material failure.     

Atherosclerotic aneurysm of the deep femoral artery. Case report

Three cases of atherosclerotic aneurysm of the deep femoral artery are described. They demonstrated the differing presentations of atherosclerotic femoral aneurysm, viz. as "asymptomatic" pulsating tumour or with manifestations of distal ischaemia or rapid growth and rupture. A search of the literature revealed 12 cases of atherosclerotic aneurysm in the deep femoral artery, and additionally 11 mentioned in review articles on femoral aneurysm. Notably, five of the 15 (including the 3 here described) cases of deep femoral artery aneurysm presented with rupture, an incidence higher than has been reported for aneurysm of the common or superficial femoral artery. The reason probably is that deep femoral aneurysms are more difficult to diagnose before they have reached a size carrying higher risk of rupture. A more aggressive approach, with operation soon after establishment of the diagnosis, is therefore proposed.     

Monstrous aneurysm of the deep femoral artery

Deep femoral artery aneurysms are a rarity among arterial aneurysms. Based on a selected case of a patient who was treated at our clinic, clinical images are presented and treatment options are discussed.     

Atherosclerotic aneurysm of the deep femoral artery

A rare case of acutely thrombosed atherosclerotic aneurysm of the deep femoral artery is herein described. A review of the literature revealed 12 other reported cases of deep femoral aneurysm. However none were treated by resection and replacement using a human umbilical vein graft which was chosen in the present case because the autogenous saphenous vein was not available.     

True aneurysm of the deep femoral artery

Aneurysms of the profunda femoris artery are very rare. The frequency of these aneurysms is 0.5-1% of all peripheral atherosclerotic aneurysms. This condition can be symptom free for an extended period of time. In one third of the patients, palpable, pulsating swelling appears in the groin. Complications such as rupture, peripherial embolism, deep vein thrombosis, depending on the condition of the arteries ischaemia in the leg can develop. Treatment of this condition according to the literature is resection of the aneurysm with reconstruction of the artery. Our practice is the same. If diagnosis is achieved surgery is necessary to avoid further complications. The literature review from 1960 presents 51 patients with the disease, we added 3 of our own cases to this number.     

Obtaining a superficial femoral artery graft in adolescents and children with the deep femoral artery transposition

A new technique to obtain a segment of the superficial femoral artery as an arterial conduit in young patients while an unobstructed peripheral blood flow is maintained by superficial femoral artery-deep femoral artery transposition is illustrated with two clinical examples. The explanted arterial autograft requires no replacement by another graft and provides a conduit of up to 10 cm in length. Excellent results were achieved in both patients at 1 year. This technique is recommended instead of saphenous vein conduits in very young patients because of the risk for late vein degeneration.     

Emergency hepato-renal artery bypass using a PTFE graft

A 51-year-old patient suffering from Buerger's disease with bilateral lower limb amputation and Leriche syndrome presented with uncontrollable hypertension and renal failure caused by right renal artery subocclusive stenosis associated with an occluded left renal artery and atrophic kidney. He underwent a right hepato-renal bypass grafting using an externally supported polytetrafluorethylene (PTFE) graft. Renal function improved markedly and hypertension could be controlled by standard antihypertensive treatment. Normal right renal function was maintained at one-year follow-up.     

Posterior approach to the deep femoral artery

Unusual surgical approaches to the deep femoral artery are valuable when the standard anterior approach is difficult because of scarring or infection. A posterior approach to the deep femoral artery in patients, in whom all other approaches were unsuitable, is described.     

Successful reimplantation of total femoral prosthesis after deep infection

A 16-year-old boy developed a deep infection with methicillin-resistant Staphylococcus aureus 6 months after total femoral replacement including knee and hip joints. The deep infection was eradicated by the use of débridement with continuous irrigation and removal of all prosthetic components followed by insertion of an antibiotic-impregnated cement spacer. Six weeks later, the total femoral prosthesis could be successfully reimplanted with both acetabular and tibial components. Two and half years later, the patient remained free of infection. Débridement with continuous irrigation and an antibiotic-impregnated cement spacer can be a feasible technique for the treatment of deep infection after large prosthetic replacement. Furthermore, reimplantation should be performed after a short waiting period. Such treatment should be considered before deciding on amputation.