Treatment of Perigraft Seroma in Expanded Polytetrafluoroethylene Grafts by Sequential Fibrin Sealing of the Outer Graft Surface

Zanow, J.; Krüger, U.; Settmacher, Utz; Scholz, Hans

doi:10.1016/j.avsg.2010.03.016

Cited by 16 publications

(11 citation statements)

References 36 publications

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“…Some authors claim an active role of fibroblasts in the process of periprosthetic region remodelling. 3,5) Since often asymptomatic, in most cases the patient arrives when the seroma has reached large dimensions. Diagnosis is based on CDUS, which assesses graft patency and collection size.…”

Section: Introductionmentioning

confidence: 99%

“…1) Although not confirmed by prospective case studies with long-term follow-up, prosthetic material changing (from Dacron to ePTFE and vice versa) has proved to be a practice used by several Authors with good results. 3,6) Other therapies have been proposed: replacement with homograft 7) or native vein, 6) fibrin glue wrapping, 5) microfibrillar collagen injection into the periprosthetic space. 8) We presented a case of large symptomatic PS after an AxBF bypass.…”

Section: Introductionmentioning

confidence: 99%

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Giant Perigraft Seroma after Axillobifemoral Bypass for Leriche’s Syndrome: A Case Report

Bissacco

Domanin

Alessandro

et al. 2016

Annals of Vascular Diseases

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Perigraft seroma is a rare complication occurs after placement of any vascular graft. It is defined as the collection of a sterile, clear and acellular liquid around prosthesis. It can appear years after surgery as a soft, palpable and painless mass. We present a perigraft seroma occurred in a 75-years-patient underwent Dacron right axillo-bifemoral bypass for Leriche's syndrome. Ultrasound and computed tomography scan revealed involvement of graft left branch and bifurcation. Although several treatment options have been proposed, removal and replacement of prosthetic affected tract with another of a different material has been proved the choice with best result.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Giant Perigraft Seroma after Axillobifemoral Bypass for Leriche’s Syndrome: A Case Report

Bissacco

Domanin

Alessandro

et al. 2016

Annals of Vascular Diseases

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“…Twenty-four patients with perigraft seroma were treated by removing the affected segments and performing sequential fibrin sealing before reimplanting the graft segments. This technique achieved a ''cure'' of perigraft seromas in 20 (84%) of the patients at a follow-up of 37 ± 18 months (8).…”

Section: Discussionmentioning

confidence: 93%

High Incidence of Perigraft Seroma Formation with Gelatin‐Coated Polytetrafluoroethylene Grafts

Ladenheim¹,

Lum²,

Chadwick³

et al. 2012

Seminars in Dialysis

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We reviewed the effectiveness of a gelatin-coated polytetrafluoroethylene (PTFE) graft designed to reduce suture line bleeding and graft weeping. Twenty-nine adults with end-stage renal disease underwent implantation the graft (n = 30) in the arm. All had preoperative ultrasound vascular mapping to assess their options for an autogenous arteriovenous fistula and patients with a history of prior central venous devices or sternotomy underwent contrast venography. A 4- to 7-mm tapered graft (n = 10) was used if the inflow artery was <4.0 mm in diameter, and a 6-mm straight graft (n = 20) was used if the artery was ≥4.0 mm. Intraoperative volume flows were measured by duplex methodology. Precautions to prevent ultrafiltration and seroma development were taken. Eleven clinically significant seromas were detected in 30 sealed PTFE grafts (36.7%), 10 in the 6-mm grafts (50%), and 1 in a 4- to 7-mm graft (10%), a significant difference between graft types. There were no significant differences in flow between the graft types and between grafts with seromas versus no seromas. Five grafts were explanted and one was ligated, resulting in cannulation delays from 2 to 4 months. We conclude that the gelatin-sealed PTFE vascular graft is not the ideal prosthesis for hemodialysis access.

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“…Other possible mechanisms include the administration of heparin, lipolysis, and damage of the graft during placement, or a subclinical infection. 5 The presence of a perigraft seroma makes graft incorporation into surrounding tissue impossible, 1 so there is no tissue ingrowth into the graft pores and porosity remains high. 6 The incidence of perigraft seroma is probably underreported, but the complication deserves attention due to the associated morbidity, e.g., graft thrombosis from compression, 4 skin necrosis, secondary graft infection, anastomotic aneurysm formation, and anastomotic bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…8 However, as we saw, needle aspiration or drainage is often ineffective. 6,9 Other options are external surface sealing by application of fibrin glue components, 5 wrapping the graft with saphenous vein, 10 or sac imbrication with suture and replacement of the graft. 4,7,9 However replacement of the graft with a new ePTFE graft results in a surprising high percentage of recurrent seroma in most reports.…”

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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Treatment of Perigraft Seroma in Expanded Polytetrafluoroethylene Grafts by Sequential Fibrin Sealing of the Outer Graft Surface

Cited by 16 publications

References 36 publications

Giant Perigraft Seroma after Axillobifemoral Bypass for Leriche’s Syndrome: A Case Report

Giant Perigraft Seroma after Axillobifemoral Bypass for Leriche’s Syndrome: A Case Report

High Incidence of Perigraft Seroma Formation with Gelatin‐Coated Polytetrafluoroethylene Grafts

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

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