Non-infectious exteriorization of femorofemoral bypass graft: A case report and review of literature

Abstract

Spontaneous exteriorization of a prosthetic vascular graft is a rare complication of vascular repair. It is even rarer when there is no evidence of an infective cause. We aim to highlight this unusual complication of vascular graft and to review the literature. We report a case of a middle-aged man who was managed for total occlusion of the left external iliac artery with a non-anatomic femorofemoral graft using Poly-Tetra-Flour-Ethylene (PTFE). Five years later, he presented with exposure to the graft without obvious signs of wound infection which is a rare complication of vascular repair. The graft was test-clamped and subsequently excised when no sign of limb ischemia was noted. The wound was refreshed and closed primarily. He is still on follow-up and has no symptoms or signs of limb ischemia. Exposure of femorofemoral bypass graft can occur due to skin erosion when the graft is in contact with the dermis. Good tunelisation and avoiding angulation of prosthesis are advised to avoid this complication.