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Surgical treatment of septic endarteritis of the iliofemoral region can result in prolonged
ischemia of the lower extremities. Distal perfusion of the limb can improve early postoperative
outcomes. We present a case of a 35-year-old woman who was diagnosed with
septic endarteritis of the right iliofemoral region as a consequence of residual wire fragments
from a prior endovascular procedure. During the intervention, the entire right
iliofemoral arterial segment was replaced with a homograft due to the destruction of native
arterial walls. Because of the extent of the replacement and predicted duration of the procedure,
we used selective distal perfusion of her right leg to minimize the possibility of
ischemia and reperfusion injury to the tissues, which is usually followed by compartment
syndrome. The patient recovered fully. This case highlights the importance of a multidisciplinary
approach when it comes to the treatment of rare and complex cases.