Disruption in “Nonanastomotic Section” of an Axillofemoral Bypass: A Thorough Critical Review of the Literature

García, Sergio Valverde; Cortés, R. Peña; Eiriz, J. Torre; Cenador, María Begoña García; Sánchez, Félix López

doi:10.1016/j.avsg.2017.06.134

Cited by 2 publications

(10 citation statements)

References 13 publications

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“…Despite this, typical post-surgical complications include local wound infection, seroma or hematoma formation, surgical site pain, graft thrombosis, and arterial steal syndrome [ 5 ]. Non-anastomotic graft fracture, however, is an extremely rare complication with few previously reported cases [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…While there are other potential complications associated with BiFAXB graft placement, the most common of which are thrombosis and infection, one of the most acutely life-threatening is graft disruption or fracture [ 5 ]. In general, a graft disruption will occur at the anastomosis site and can result from a variety of causes, the most common being trauma or infection [ 5 ]. Non-anastomotic graft fracture is extremely rare and can typically be directly attributed to a specific etiology [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…In general, a graft disruption will occur at the anastomosis site and can result from a variety of causes, the most common being trauma or infection [ 5 ]. Non-anastomotic graft fracture is extremely rare and can typically be directly attributed to a specific etiology [ 5 ]. Having a discrete incident that leads to symptom development can help physicians to narrow down their diagnostic differential much more rapidly, thus allowing for a quicker transfer to higher levels of care [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…POCUS, additionally, may play an essential role in early diagnosis of rarer conditions such as graft disruption, as seen here, and potentially other, less common post-surgical complications. Only a few cases of non-anastomotic axillary bypass graft disruption have been previously described in the literature [ 5 , 10 , 11 ]. The vast majority of fractures are in PTFE grafts secondary to blunt trauma [ 5 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Only a few cases of non-anastomotic axillary bypass graft disruption have been previously described in the literature [ 5 , 10 , 11 ]. The vast majority of fractures are in PTFE grafts secondary to blunt trauma [ 5 , 9 , 10 ]. We discuss a patient who presented with atraumatic BiFAXB PTFE graft disruption and the impact bedside POCUS had on both the diagnosis of this unique condition and expedition of patient care.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Atraumatic Bi-femoral Axillary Bypass Graft Non-anastomotic Disruption With Pseudoaneurysm Formation Detected by Doppler Ultrasound

Nesbit¹,

Wang²,

Grenz³

et al. 2022

Cureus

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Bi-femoral axillary bypass graft placement is a well-known and typically safe procedure. It is generally indicated for patients with advanced peripheral vascular disease, aortoiliac occlusive disease, or infectious artery disease. In rare cases, the graft can be fractured or dislodged after placement, though most often, this occurs almost exclusively at the anastomosis site, secondary to blunt trauma. Using ultrasonic imaging is a reliable method of detecting these fractures. We present a case of a bi-femoral axillary bypass graft fracture in a 68-year-old male with the development of a pseudoaneurysm in the right lateral abdominal wall. The patient reported spontaneous development of a "strange" sensation in his right lower abdomen and a "painful lump" upon waking. Physical examination showed a small right lower quadrant outpouching which was pulsatile on palpation. The initial workup included a bedside ultrasound which showed a fractured graft with the fluid collection and a Doppler signal. Vascular surgery was immediately consulted for evaluation, and the patient was taken to the operating room for emergent surgical repair. CT angiography confirmed a successful operation in which an 8 mm graft was placed to anastomose the original bypass graft fracture site. The patient remained stable postoperatively and was discharged without further complications. This report highlights the importance of using ultrasonography for the immediate identification of potential graft complications to prevent serious complications and expedite definitive management.

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Section: Discussionmentioning

confidence: 99%