Back to Search
Start Over
Perigraft Seroma after Extra-anatomic Bypass: Case Series and Review of the Literature
- Source :
- Annals of Vascular Surgery. 44:451-458
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background Extra-anatomic bypass (EAB) remains a viable alternative for lower limb revascularization if aorto-bifemoral bypass and endovascular therapy are contraindicated. Among EAB, perigraft seroma (PS) occurs in about 4% of cases. Diagnostic and therapeutic management, as well as standardized treatment paradigm, are still not well defined. The aim of this study is to report 5 PS cases in EAB and to review the literature about similar cases. Methods We retrospectively reviewed EAB performed during the period 2002–2015. Among these, PS cases were analyzed. A similar description for all cases found in the literature through research on the major international databases (PubMed, Scopus, EMBASE) was conducted. Results During the study period, 797 bypasses—528 (66.3%) anatomical and 269 (33.7%) extra-anatomical—were performed. Among the latter, 169 femoro-femoral (FF), 20 axillo-femoral (AXF), 22 axillo-bifemoral (AxBF), and 58 aortouni-iliac endoprosthesis (AUI) + FF bypasses were performed. Five cases (1.86%) of PS in EAB population were detected: 3 after AxBF and 2 after AUI + FF. Although we initially preferred percutaneous drainage, a surgical choice with graft explant and replacement were imposed by the high recurrence rate. Literature analysis identified 20 additional cases (11 after AxBF, 7 after AXF and one after AUI + FF). Conclusions Our case series and the literature confirm that the most widely used therapy is the surgical drainage with primary or secondary replacement of the graft of a different material. Percutaneous drainage has proved to be ineffective because not conclusive and potential to increase risk of graft infection. Careful follow-up, even years after surgery, remains necessary for PS diagnosis and management, to prevent complications and potential infection.
- Subjects :
- Male
medicine.medical_specialty
Percutaneous
medicine.medical_treatment
Population
030204 cardiovascular system & hematology
030230 surgery
Revascularization
Blood Vessel Prosthesis Implantation
03 medical and health sciences
0302 clinical medicine
Recurrence
Risk Factors
Blood vessel prosthesis
Perigraft seroma
Humans
Medicine
education
Device Removal
Aged
Retrospective Studies
Aged, 80 and over
education.field_of_study
business.industry
Extra anatomic bypass
Retrospective cohort study
General Medicine
Blood Vessel Prosthesis
Surgery
Seroma
Treatment Outcome
Drainage
Female
Cardiology and Cardiovascular Medicine
business
High recurrence rate
Subjects
Details
- ISSN :
- 08905096
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Annals of Vascular Surgery
- Accession number :
- edsair.doi.dedup.....2f70348c8c91607c8eccafd829871456