ArticleVascular specialist international2022
Leriche Syndrome with Digital Gangrene: Is Aortic Bypass Grafting Safe in Intravenous Drug Abusers? A Case Report and Literature Review.
Article in Vascular specialist international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
A 47-year-old male with Leriche syndrome presented with digital gangrene due to TASC II type-D occlusion of the distal aorta and common iliac arteries. Open revascularization was performed using a Dacron aorto-biiliac bypass graft; however, the postoperative course revealed a nondisclosed history of intravenous opioid abuse as he went into withdrawal psychosis. Our report highlights ways to mitigate infection risk associated with prosthetic aortic grafts in suspected or confirmed intravenous drug abusers. The literature review suggests alternative strategies like aortoiliac endarterectomy, total endovascular approach using non-covered stents, or a hybrid approach. The primary use of autologous venous grafts should be considered as a last resort so that the veins are retained for future use in case of graft infection. Patient factors like comorbidities, fitness to undergo surgery, anatomical extent of occlusion, and availability of facilities/expertise can further guide the management plan owing to a lack of evidence-based guidelines.
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