PMC5576156_01
Skin lesions of septic embolism in the left lower limb (A: left foot; B: left thigh; C: left leg calf region).
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On physical examination there were skin signs of distal embolisation in the left lower limb (Fig. 1), extending to skin ulceration in some areas.
Computed tomography angiography showing the left common iliac artery pseudoaneurysm related to the stent implantation site (white arrow); axial and sagittal views (A, B); three dimensional volume rendered reconstruction of the computed tomography angiogram (C, D).
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Right superficial femoral vein harvest.
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The right superficial femoral vein was harvested (Fig. 3) and transperitoneal aorto-iliac exposure was performed through a midline laparotomy.
Surgery procedure images. (A) Resection of the segment of common iliac artery with the implanted stents at the aortic bifurcation (stent struts visible). (B) Aortic bifurcation after excision of the affected iliac segment (IVC, inferior vena cava). (C) Proximal anastomosis of the interposition superficial femoral vein conduit. (D) Distal anastomosis. (E) Iliac arterial wall and stents explanted.
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After thorough cleansing of the surrounding tissue with saline solution, an interposition vein graft was constructed restoring patency of the left iliac segment (Fig. 4).