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Giant Perigraft Seroma after Axillobifemoral Bypass for Leriche's Syndrome: A Case Report
Daniele Bissacco1, Maurizio Domanin1, Alessandro Del Gobbo2
1IRCCS Ca' Granda Ospedale Maggiore Policlinico, Vascular Surgery Department, Milan, Italy.
Abstract:
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.
Insights
Perigraft seroma, a rare complication after vascular graft surgery, presents as a sterile fluid collection. Surgical removal and replacement with a different material offer the best treatment outcome.
Area of Science:
- Vascular Surgery
- Surgical Complications
- Biomaterials
Background:
- Perigraft seroma is a rare complication following vascular graft procedures.
- It is characterized by a sterile, acellular fluid collection around the prosthesis.
- Seromas can manifest years post-surgery as asymptomatic, palpable masses.
Observation:
- A case of perigraft seroma in a 75-year-old patient is presented.
- The patient had undergone a Dacron right axillo-bifemoral bypass for Leriche's syndrome.
- Imaging revealed involvement of the graft's left branch and bifurcation.
Findings:
- Ultrasound and computed tomography scans confirmed the perigraft seroma.
- The seroma impacted the Dacron graft, specifically its left branch and bifurcation.
Implications:
- While various treatments exist, complete removal and replacement of the affected graft segment are recommended.
- Utilizing a different biomaterial for replacement may improve outcomes.
- This case highlights the importance of recognizing and managing late-onset perigraft seromas.