Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faith

Infection of fenestrated-branched stent graft is an uncommon but potentially catastrophic complication. The technical challenge of total stent graft explant and reconstruction of the renal-mesenteric arteries is associated with high mortality and morbidity. Among patients of Jehovah Witness faith, r...

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Main Authors: Carlotta Bugna, MD, Lucas Ruiter Kanamori, MD, Priscila Suguita, MD, Ezra Koh, MD, Thanila A. Macedo, MD, Gustavo S. Oderich, MD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S246842872500098X
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author Carlotta Bugna, MD
Lucas Ruiter Kanamori, MD
Priscila Suguita, MD
Ezra Koh, MD
Thanila A. Macedo, MD
Gustavo S. Oderich, MD
author_facet Carlotta Bugna, MD
Lucas Ruiter Kanamori, MD
Priscila Suguita, MD
Ezra Koh, MD
Thanila A. Macedo, MD
Gustavo S. Oderich, MD
author_sort Carlotta Bugna, MD
collection DOAJ
description Infection of fenestrated-branched stent graft is an uncommon but potentially catastrophic complication. The technical challenge of total stent graft explant and reconstruction of the renal-mesenteric arteries is associated with high mortality and morbidity. Among patients of Jehovah Witness faith, refusal to accept blood transfusion adds to the risk given the invasiveness of these operations. We report a Jehovah's Witness faith patient with a recurrent infection of a four-vessel fenestrated and bilateral iliac branch stent graft treated in two stages by axillofemoral bypass, followed by extra-anatomical reconstruction of the mesenteric, renal, and left internal iliac arteries and total stent graft explant and aortic stump closure.
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id doaj-art-1b90e79d4c294546a7e2f99e91e3cd4b
institution Kabale University
issn 2468-4287
language English
publishDate 2025-08-01
publisher Elsevier
record_format Article
series Journal of Vascular Surgery Cases and Innovative Techniques
spelling doaj-art-1b90e79d4c294546a7e2f99e91e3cd4b2025-08-20T03:35:44ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872025-08-0111410181610.1016/j.jvscit.2025.101816Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faithCarlotta Bugna, MD0Lucas Ruiter Kanamori, MD1Priscila Suguita, MD2Ezra Koh, MD3Thanila A. Macedo, MD4Gustavo S. Oderich, MD5Department of Vascular Surgery, Vita-Salute University, IRCCS San Raffaele Scientific Institute, Milan, ItalyAdvanced Endovascular Aortic Research Program, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TXDepartment of Cardiothoracic & Vascular Surgery, The University of Texas Health Science Center at Houston, Houston, TXAdvanced Endovascular Aortic Research Program, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TXAdvanced Endovascular Aortic Research Program, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TXAdvanced Endovascular Aortic Research Program, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Correspondence: Gustavo S. Oderich, MD, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Center for Aortic Surgery, Baylor College of Medicine, 7200 Cambridge St, Ste 2B, Houston, TX 77030Infection of fenestrated-branched stent graft is an uncommon but potentially catastrophic complication. The technical challenge of total stent graft explant and reconstruction of the renal-mesenteric arteries is associated with high mortality and morbidity. Among patients of Jehovah Witness faith, refusal to accept blood transfusion adds to the risk given the invasiveness of these operations. We report a Jehovah's Witness faith patient with a recurrent infection of a four-vessel fenestrated and bilateral iliac branch stent graft treated in two stages by axillofemoral bypass, followed by extra-anatomical reconstruction of the mesenteric, renal, and left internal iliac arteries and total stent graft explant and aortic stump closure.http://www.sciencedirect.com/science/article/pii/S246842872500098XFenestrated endovascular aneurysm repair (F-EVAR)Stent graft infectionJehovah's WitnessAortic explantationExtra-anatomical bypass
spellingShingle Carlotta Bugna, MD
Lucas Ruiter Kanamori, MD
Priscila Suguita, MD
Ezra Koh, MD
Thanila A. Macedo, MD
Gustavo S. Oderich, MD
Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faith
Journal of Vascular Surgery Cases and Innovative Techniques
Fenestrated endovascular aneurysm repair (F-EVAR)
Stent graft infection
Jehovah's Witness
Aortic explantation
Extra-anatomical bypass
title Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faith
title_full Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faith
title_fullStr Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faith
title_full_unstemmed Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faith
title_short Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faith
title_sort explant of an infected four vessel fenestrated and bilateral iliac branch stent graft in a patient of jehovah s witness faith
topic Fenestrated endovascular aneurysm repair (F-EVAR)
Stent graft infection
Jehovah's Witness
Aortic explantation
Extra-anatomical bypass
url http://www.sciencedirect.com/science/article/pii/S246842872500098X
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