Subject(s)
Axillofemoral Bypass Grafting/adverse effects , Blood Vessel Prosthesis/adverse effects , Cutaneous Fistula/etiology , Graft Occlusion, Vascular/etiology , Prosthesis-Related Infections/etiology , Sepsis/etiology , Anti-Bacterial Agents/therapeutic use , Aorta/surgery , Axillofemoral Bypass Grafting/instrumentation , Computed Tomography Angiography , Cutaneous Fistula/diagnosis , Cutaneous Fistula/therapy , Device Removal , Graft Occlusion, Vascular/diagnosis , Graft Occlusion, Vascular/therapy , Humans , Male , Middle Aged , Prosthesis-Related Infections/diagnosis , Prosthesis-Related Infections/therapy , Sepsis/diagnosis , Sepsis/therapy , Thrombosis/surgeryABSTRACT
A 70-year-old woman underwent an axillobifemoral artery bypass using a bifurcated ring-supported Dacron graft in 2004 and then noticed a pulsatile mass in the left flank 10 years later. A Fogarty thrombectomy was performed for acute graft occlusion. Eight months later, computed tomography revealed pseudoaneurysm formation in the graft body and surgical graft interposition was performed. The operative findings showed a transverse rupture of the graft just above the bifurcation. Histological findings revealed graft deterioration with filaments broken off from the graft. Although the cause of pseudoaneurysm formation was not apparent, the combination of graft deterioration and additional damage from the Fogarty thrombectomy was highly suspicious.