Explanted Vascular and Endovascular Graft Analysis: Where Do We Stand and What Should We Do?

Lejay, Anne; Colvard, Benjamin; Magnus, L; Dion, Delphine; Georg, Yannick; Papillon, J.; Thaveau, Fabien; Gény, Bernard; Swanström, Lee L.; Heim, Frédéric; Chakfé, Nabil

doi:10.1016/j.ejvs.2018.01.022

Cited by 27 publications

(10 citation statements)

References 23 publications

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“…3 On the other hand, the search for a compliant structure can lead to favouring very light textiles whose long term durability and stability might be questionable and lead to the risk of degradation, dilatation, or rupture. 33…”

Section: Discussionmentioning

confidence: 99%

Compliance of Textile Vascular Prostheses Is a Fleeting Reality

Lucereau

Koffhi

Lejay

et al. 2020

European Journal of Vascular and Endovascular Surgery

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Section: Discussionmentioning

confidence: 99%

Compliance of Textile Vascular Prostheses Is a Fleeting Reality

Lucereau

Koffhi

Lejay

et al. 2020

European Journal of Vascular and Endovascular Surgery

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“…Complete analysis of failure mechanisms, even from an isolated report, is therefore mandatory 9 . Even with a small amount of material, a standardised protocol of analysis including clinical data collection, pre-operative imaging, meticulous macroscopic examination of the ruptured graft, cleaning with dedicated processes followed by high magnification microscopy and scanning electron microscopy can help in determining the rupture profile, while in vitro analysis might be helpful to evaluate the mechanical behaviour of the grafts through longitudinal tensile stress, circumferential tensile stress, and burst strength 10 …”

Section: Discussionmentioning

confidence: 99%

Non-Anastomotic Complete ePTFE Axillobifemoral Bypass Disruption and Thrombosis Following Shoulder Dislocation

Lucereau

Bellissard

Beck

et al. 2019

EJVES Short Reports

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Complete disruption of an expanded polytetrafluoroethylene (ePTFE) vascular graft is rare. This is a report of a case of a 70 year old man presenting with left shoulder dislocation, which was reduced immediately. Two weeks later, the patient presented with Rutherford 2b bilateral lower limb ischaemia related to the thrombosis of an ePTFE axillobifemoral bypass. The graft was implanted five years earlier for treatment of an aorto-enteric fistula secondary to an infected aortobifemoral bypass. A non-anastomotic pseudoaneurysm associated with complete disruption of the ePTFE graft was found. Systematic analysis of the explant showed that the rupture occurred at the level of a ringed external support and that ongoing tears also occurred on the posterior wall of the graft at the level of this external support. In conclusion, complete analysis of failure mechanisms even from an isolated report is mandatory.

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“…In conclusion, when a problem is identified, it is better to solve it immediately, rather than waiting for possible complications, even in elderly patients. Moreover, it is mandatory to evaluate any explanted material in the future 9, 10…”

Section: Discussionmentioning

confidence: 99%

Knee Implant Dislocation Leading to Major Amputation 13 Years Later

Kuntz

Lejay

Virmani

et al. 2019

EJVES Short Reports

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Introduction Injury to the popliteal vessels during total knee replacement is rare but can lead to catastrophic outcomes. Report An 81 year old female presented with Rutherford IIb acute left limb ischaemia (ALI) 13 years after total knee replacement. The polyethylene insert in the knee implant had dislocated from the other components and had moved into the popliteal fossa, leading to popliteal artery compression. She underwent emergency multidisciplinary surgery including removal of the polyethylene component, thrombectomy, and popliteal artery stenting, but major amputation was required. The popliteal artery and the stent were removed and submitted to histological analysis. The stent was well expanded but focal malapposition was observed. Conclusion Regular follow up is mandatory in order to anticipate malfunction of the prosthesis and avoid long term complications.

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Explanted Vascular and Endovascular Graft Analysis: Where Do We Stand and What Should We Do?

Abstract: A general lack of depth of reporting of explants remains. Dedicated systematic explant analysis programs are the key to improving the performance of future generations of devices.

Cited by 27 publications

References 23 publications

Compliance of Textile Vascular Prostheses Is a Fleeting Reality

Compliance of Textile Vascular Prostheses Is a Fleeting Reality

Non-Anastomotic Complete ePTFE Axillobifemoral Bypass Disruption and Thrombosis Following Shoulder Dislocation

Knee Implant Dislocation Leading to Major Amputation 13 Years Later

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