Our Summary

This study describes a rare case of a 55-year-old man who had a swollen artery in his leg, which is commonly known as a popliteal artery aneurysm (PAA). This condition is typically caused by bacteria, but in this case, the bacteria was a type not previously associated with this condition, called Staphylococcus epidermidis. The man first complained of leg pain and swelling, tiredness, and low-grade fever for two weeks. The doctors decided to use a bypass graft to treat the aneurysm. However, after 10 days, his leg started swelling again and he was unable to move his foot. A scan showed that the aneurysm had gotten bigger very quickly, so he had to have emergency surgery to remove it. The doctors found that the Staphylococcus epidermidis bacteria had caused the problem. They concluded that if a PAA gets bigger quickly or bursts after surgery, it could be a sign of an infection.

FAQs

  1. What is a popliteal artery aneurysm (PAA) and what typically causes it?
  2. How was the PAA treated in the 55-year-old patient in this study?
  3. What was the significance of the Staphylococcus epidermidis bacteria in this patient’s case?

Doctor’s Tip

A helpful tip a doctor might tell a patient about femoral-popliteal bypass is to closely monitor the surgical site for any signs of infection, such as increased swelling, redness, warmth, or drainage. It is important to seek medical attention promptly if any of these symptoms occur, as an infection can lead to serious complications and may require additional treatment. Additionally, following post-operative care instructions, including taking prescribed medications and attending follow-up appointments, can help ensure a successful recovery from the procedure.

Suitable For

Patients who are typically recommended for femoral-popliteal bypass surgery include those with severe peripheral arterial disease (PAD) in the lower extremities, specifically in the femoral and popliteal arteries. This may include individuals with:

  1. Severe claudication (leg pain while walking)
  2. Critical limb ischemia (severe blockage in the arteries leading to pain at rest and non-healing wounds)
  3. Popliteal artery aneurysms
  4. Acute limb ischemia (sudden blockage in the arteries leading to a lack of blood flow to the leg)
  5. Chronic total occlusion of the femoral or popliteal arteries

These patients may have symptoms such as leg pain, numbness, coldness, weakness, non-healing wounds, or tissue loss in the affected limb. They may also have risk factors such as smoking, diabetes, hypertension, high cholesterol, or a history of cardiovascular disease.

Ultimately, the decision to recommend femoral-popliteal bypass surgery is based on a thorough evaluation by a vascular surgeon, taking into consideration the severity of the patient’s condition, their overall health, and the potential benefits and risks of the procedure.

Timeline

  • Initial symptoms: Leg pain, swelling, tiredness, low-grade fever
  • Diagnosis of popliteal artery aneurysm (PAA)
  • Decision to undergo femoral-popliteal bypass surgery
  • Post-surgery recovery period
  • Sudden increase in leg swelling and inability to move foot
  • Emergency surgery to address complications
  • Discovery of Staphylococcus epidermidis infection as cause of complications
  • Conclusion drawn about potential signs of infection in case of rapid growth or bursting of PAA after surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with femoral-popliteal bypass surgery?
  2. How long is the recovery period after femoral-popliteal bypass surgery?
  3. What symptoms should I watch out for that may indicate a complication or infection after surgery?
  4. Are there any lifestyle changes or medications I will need to take after the surgery?
  5. How often should I follow up with my doctor after the surgery?
  6. Are there any specific activities or exercises I should avoid after the surgery?
  7. What signs or symptoms should prompt me to seek immediate medical attention post-surgery?
  8. Are there any long-term effects or risks associated with having a femoral-popliteal bypass?
  9. Will I need any additional tests or imaging studies to monitor the success of the surgery?
  10. Are there any alternative treatment options available for my condition other than femoral-popliteal bypass surgery?

Reference

Authors: Lajos P, Bangiyev R, Safir S, Weber T. Journal: Cureus. 2021 Jun 18;13(6):e15746. doi: 10.7759/cureus.15746. eCollection 2021 Jun. PMID: 34285852