Nonanastomotic Aneurysm Formation in a Dacron Arterial Graft: report of a Case

Abstract

Dacron prostheses are the most widely used grafts in replacement procedures for abdominal aortic aneurysms, having been proven as the most reliable substitute for arterial replacement. However, we present herein the rare case of an 82-year-old woman in whom nonanastomotic aneurysm formation occurred in the graft as a complication associated with a Dacron prosthesis. The patient presented with a pulsatile mass in the right inguinal region. She had undergone surgery 13 years earlier for an abdominal aortic aneurysm, at which time an aortobifemoral graft reconstruction had been performed with a double-velour knitted Dacron prosthesis. The pulsatile mass was found to be a nonanastomotic aneurysm of the right limb of the bifurcated graft with an intact distal anastomosis. In this case, the development of the graft aneurysm seemed to result from deterioration of the Dacron prosthesis itself due to mechanical fatigue caused by the inguinal band.

Old Myths, New Concerns: the Long-Term Effects of Ascending Aorta Replacement with Dacron Grafts. Not All That Glitters Is Gold

“…Beside the caveat related to the fact that this evaluation was performed in thoracic descending aorta, with a known difference in hemodynamics compared to ascending aorta, the results are in agreement with previous data published by Mattens et al reporting a 31.4 % dilation over 2-year follow-up with a similar per-year rate of increase [ 25 ]. Early studies from Berger et al [ 26 ] showed alterations in the microstructure of Dacron grafts that may translate into different degrees of graft dilatation [ 2 ] or rarely determine graft rupture due to material fatigue [ 27 , 28 ]. However, the physical changes in the yarn architecture together with the in vivo material degradation in contact with biological fluids determine loss of elasticity and change in compliance of the graft that is further responsible of the dilation profile shown by these prostheses [ 29 , 30 ] and their functional consequences [ 1 ].…”

Late Nonanastomotic Pseudoaneurysm From the Prosthetic Graft: A Successful Transcatheter Arterial Embolization Using Coils

“…4 This dilatation weakened the graft wall and resulted in fiber breakdown and eventual graft rupture. 5 Conversely, Hiraoka et al 1 reported that post-implantation dilatation did not necessarily imply increased risk of rupture. Nonanastomotic pseudoaneurysm occurred mostly after aortobifemoral bypass, 6 but very rarely after TAR 1 and caused by the following 2 elements: graft side including mechanical fatigue, damage during handling, structural defects, and biological reactions; and host side including chronic mechanical stress such as the inguinal band and costal arch.…”

Treatment of Dacron Grafting Dilatation with Endovascular Stent Graftıng

“…Graft patency rates are quite promising in selected patients and revascularization locations; however, the procedures are not event free [4]. Complications include infection, graft thrombosis, pseudoaneurysm, aneurysm or dilatation, and rupture [5].…”

“…The most common complications are infection and graft thrombosis; Dacron graft aneurysms are very rare disorders. This complication is reported to occur in 1-3% of patients with graft replacement and are usually seen 4-6 years after surgery [5]. The first report on this disorder mentioned aneurysmal dilatation of Dacron graft 5.5 years after surgical treatment [7].…”