Postoperative Alterations in Size of Dacron Aortic Grafts: An Ultrasonic Evaluation

Nunn, Daniel B.; Freeman, Marc H.; Hudgins, Paul C.

doi:10.1097/00000658-197906000-00010

Cited by 109 publications

(30 citation statements)

References 6 publications

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“…7) Long term degradation is a complication of polyester vascular prostheses, including knitted Dacron grafts, that might lead to dilation or prosthetic rupture. [8][9] Degradation might be related to several factors, such as the structural nature of the textile, changes in the prosthesis during the manufacturing process or during implantation by handling or clamping. Secondary physicochemical alterations when the prosthesis is exposed to a chronic inflammatory reaction to foreign bodies and systolo-diastolic arterial stress might also contribute to degradation.…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm in the Left Groin due to Ruptured Knitted Dacron Graft

Ryugo

Yasugi

Nagashima

et al. 2011

Annals of Vascular Diseases

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A n 82-year-old man with claudication due to aortoiliac occlusive disease in both legs was treated in 1988 at another hospital by an aorto-bifemoral bypass using a bifurcated Cooley double velour knitted Dacron (CD-VKD) graft. He was admitted to our institution in 2007 with a pseudoaneurysm of the proximal anastomotic site, and treated by endovascular aortic repair using a handmade stent graft via an approach from the right limb of the bifurcated graft (Fig. 1a).He was admitted to our institution again in January 2010 with a painful pulsating mass in the left groin. The left dorsal pedal and posterior tibial arteries were palpable and the thigh was slightly swollen due to compression of the femoral vein by the mass. Computed tomography (CT) indicated a 35-mm para-anastomotic pseudoaneurysm of the left limb of the graft that was not detected in 2007 (Fig. 1b). The graft was replaced to avoid rupture of this aneurysm.The operation proceeded under general anesthesia with the patient in the supine position. The proximal site of the aneurysm of the previous bypass graft just above the inguinal ligament, as well as the superficial and deep femoral arteries, were encircled and clamped. Opening the aneurysmal wall and removing some thrombus revealed a Dacron graft that had become disrupted along the guideline (Fig. 2). No changes were evident at the previous anastomotic portion. The area from the intact part of the Dacron graft to the native superficial femoral artery was replaced with an 8-mm-ringed expanded polytetrafluoroethylene (ePTFE) graft, and we reconstructed the deep femoral artery using an interposed 8-mm ringed ePTFE graft.A postoperative CT scan did not confirm an inappropriate blood flow in the operative area and also showed a patent reconstructed ePTFE graft. Microscopic examination of the resected specimen revealed a relatively loose array of fibers, a few seeds of intimal cells and inflammatory cell infiltration at the site of the guideline, indicating that the Dacron graft had deteriorated (Fig. 3). The postoperative course of the patient was uneventful except for prolonged wound healing due to chronic perianeurysmal inflammatory changes, and he was discharged two months after the operation. Pseudoaneurysm in the Left Groin due to Ruptured Knitted Dacron GraftMasahiro Ryugo, MD, Takumi Yasugi, MD, Mitsugi Nagashima, MD, Hironori Izutani, MD, Toru Okamura, MD, Fumiaki Shikata, MD, Masashi Kawamura, MD, and Kanji Kawachi, MD An 82-year-old man was admitted to our institution with a painful pulsating mass in the left groin. He had undergone bypass surgery with a bifurcated Cooley double velour knitted Dacron graft to treat aorto-iliac occlusive disease 21 years previously. Computed tomography demonstrated a 35-mm pseudoaneurysm near the distal anastomosis site of the graft. Opening the aneurysm revealed that the graft was disrupted along the guideline. We resected the aneurysm and interposed an expanded polytetrafluoroethylene (ePTFE) graft. Vascular surgeons should consider that grafts can fail in patien...

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Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm in the Left Groin due to Ruptured Knitted Dacron Graft

Ryugo

Yasugi

Nagashima

et al. 2011

Annals of Vascular Diseases

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“…Homografts are obviously the best choice, but their availability is limited and many factors, including multiple bypass surgery, repeat procedures and age of the patient, decrease their suitability [2]. An alternative to homografts are synthetic grafts [3][4][5][6]. Synthetic grafts generally have a lower level of patency because practically all materials are somewhat thrombogenic and clogging of implanted grafts is a common problem [7].…”

Section: Introductionmentioning

confidence: 99%

Influence of nanopatterns on endothelial cell adhesion: Enhanced cell retention under shear stress

Zorlutuna¹,

Rong²,

Vadgama³

et al. 2009

Acta Biomaterialia

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“…In our patients with Marfan's syndrome these larger reflected waves may form a threat for the button of main side branches at reimplantation sites [7,8]. In the long term, dilation of the graft may be another risk factor for these patients, as Nunn et al found that the degree of dilation tended to be more marked in hypertensive than in normotensive patients [21]. Therefore, patients with a prosthetic aorta will benefit from medication which reduces wave reflections.…”

Section: Wave Reflectionsmentioning

confidence: 78%