Explant and Bypass for Polymicrobial Mycotic Pseudoaneurysm Following Renal Transplant.
Hanna D Sun, William J Lain, Erin Buchanan et al.
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Case in brief
A renal transplant patient developed a polymicrobial mycotic pseudoaneurysm, which was initially treated with repeated endovascular stent placements. However, this approach led to biofilm formation and persistent infection. Ultimately, the patient required surgical explant of the affected graft and a femoral-femoral bypass for definitive management and revascularization.
Diagnostic / clinical pearl
In cases of mycotic pseudoaneurysms in renal transplant patients, reliance on endovascular techniques may be inadequate, particularly with angioinvasive molds, necessitating early surgical intervention.
Why it matters
This case underscores the importance of recognizing the limitations of endovascular treatments in the presence of polymicrobial infections, advocating for timely surgical source control to prevent complications.