Frequency, risk factors, and management of perigraft seroma after open abdominal aortic aneurysm repair

Kadakol, Ajith K.; Nypaver, Timothy J.; Lin, Judith C.; Weaver, Mitchell R.; Karam, Joseph; Reddy, Daniel J.; Haddad, Georges; Shepard, Alexander D.

doi:10.1016/j.jvs.2011.03.258

Cited by 49 publications

(60 citation statements)

References 21 publications

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“…The symptoms of PGS vary depending on the site of formation. An asymptomatic mass, 2 ) pain, acute limb ischemia secondary to graft limb compression, 5 ) and respiratory distress 3 ) have been reported. Identification of a PGS in the clinical setting is difficult, and the condition remains a diagnosis of exclusion.…”

Section: Discussionmentioning

confidence: 99%

“…The differential diagnoses include infection, false aneurysm, postoperative hematoma, and lymphatic fluid collection. Kadakol et al 5 ) defined PGS as a perigraft fluid collection present for >3 months postoperatively with a diameter of ≥3.0 cm and radiodensity of ≤25 HU. The present case met all three of these criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Other authors have reported that all cases of PGS were associated with PTFE grafts. 5 , 7 ) Kadakol et al 5 ) reported that diabetes, smoking, anticoagulation, bifurcated graft reconstruction, and the left flank retroperitoneal approach were independent risk factors for the development of a PGS after open repair of an AAA.…”

Section: Discussionmentioning

confidence: 99%

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Mediastinal Perigraft Seroma after Repair of Type A Dissection with a Polyester Graft

Yamauchi

Kubota

Hagawa

et al. 2017

Annals of Vascular Diseases

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Perigraft seromas are uncommon after surgical repair of the thoracic aorta with woven polyester grafts. A 50-year-old woman required redo sternotomy for the treatment of a perigraft seroma 6 months after total arch replacement for acute type A dissection. After removal of a jelly-like mass, a prosthetic graft was covered with fibrin glue, and the bilateral pleurae beside the graft were opened widely for drainage of effusion into the bilateral pleural cavities. Bacterial culture and laboratory and histological examination of the content confirmed the final diagnosis of perigraft seroma. No evidence of recurrence was observed 4 months after drainage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mediastinal Perigraft Seroma after Repair of Type A Dissection with a Polyester Graft

Yamauchi

Kubota

Hagawa

et al. 2017

Annals of Vascular Diseases

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“…[4, 28–41] Amongst other complications, seroma and fabric contraction have been documented after implantation of PET products. [34, 37, 38, 42] Thus, PEI-mediated siRNA coating of PET may be used to address these aspects of wound healing and thereby improve biocompatibility and longevity of medical devices such as hernia meshes and others.…”

Section: Discussionmentioning

confidence: 99%

Gene silencing in human aortic smooth muscle cells induced by PEI–siRNA complexes released from dip-coated electrospun poly(ethylene terephthalate) grafts

et al. 2014

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An excessive tissue response to prosthetic arterial graft material leads to intimal hyperplasia (IH), the leading cause of late graft failure. Seroma and abnormal capsule formation may also occur after prosthetic material implantation. The matricellular protein Thrombospondin-2 (TSP-2) has shown to be upregulated in response to biomaterial implantation. This study evaluates the uptake and release of small interfering RNA (siRNA) from unmodified and surface functionalized electrospun PET graft materials. ePET graft materials were synthesized using electrospinning technology. Subsets of the ePET materials were then chemically modified to create surface functional groups. Unmodified and surface-modified ePET grafts were dip-coated in siRNAs alone or siRNAs complexed with transfection reagents polyethyleneimine (PEI) or Lipofectamine RNAiMax. Further, control and TSP-2 siRNA-PEI complex treated ePET samples were placed onto a confluent layer of human aortic smooth muscle cells (AoSMCs). Complexation of all siRNAs with PEI led to a significant increase in adsorption to unmodified ePET. TSP-2 siRNA-PEI released from unmodified-ePET silenced TSP-2 in AoSMC. Regardless of the siRNA-PEI complex evaluated, AoSMC migrated into the ePET. siRNA-PEI complexes delivered to AoSMC from dip-coated ePET can result in gene knock-down. This methodology for siRNA delivery may improve the tissue response to vascular and other prosthetics.

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“…1 It is uncertain whether seroma involving Dacron and ePTFE grafts is caused by the same mechanisms, but it is obviously more frequent with the latter. 4 The larger pore size of ePTFE (~30 lm in size) compared to Dacron may play a role in the pathogenesis of perigraft seroma. Unknown patient or procedure-specific factors may impact the porosity of ePTFE grafts, leading to leakage (ultrafiltration) through the graft wall, eventually resulting in perigraft seroma.…”

Section: Discussionmentioning

confidence: 99%

Endoluminal Stent-Graft Relining of Visceral Artery Bypass Grafts to Treat Perigraft Seroma

Lachat¹,

Toledo²,

Glenck³

et al. 2013

Journal of Endovascular Therapy

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PURPOSE: To describe the endovascular treatment of intra-abdominal perigraft seromas associated with small-caliber expanded polytetrafluoroethylene (ePTFE) grafts. CASE REPORTS: Two patients who underwent hybrid repair of thoracoabdominal aortic aneurysms in which renovisceral bypass grafts were implanted presented with large, symptomatic perigraft seromas. The 5-to 8-mm-diameter ePTFE bypass grafts believed to be involved in the seromas were successfully relined with self-expanding Viabahn stent-grafts in percutaneous procedures. The patients' symptoms were relieved, and imaging follow-up (18 and 10 months, respectively) has shown near complete resorption of the seromas. CON-CLUSION: It is expected that this minimally invasive technique could be very valuable in treating aortic, renovisceral, and peripheral perigraft seroma.

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Frequency, risk factors, and management of perigraft seroma after open abdominal aortic aneurysm repair

Cited by 49 publications

References 21 publications

Mediastinal Perigraft Seroma after Repair of Type A Dissection with a Polyester Graft

Mediastinal Perigraft Seroma after Repair of Type A Dissection with a Polyester Graft

Gene silencing in human aortic smooth muscle cells induced by PEI–siRNA complexes released from dip-coated electrospun poly(ethylene terephthalate) grafts

Endoluminal Stent-Graft Relining of Visceral Artery Bypass Grafts to Treat Perigraft Seroma

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