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Non-Anastomotic Complete ePTFE Axillobifemoral Bypass Disruption and Thrombosis Following Shoulder Dislocation
Benoît Lucereau1,2, Arielle Bellissard1,2, Frédéric Beck3
1Groupe Européen de Recherche sur les Prothèses Appliquées à la Chirurgie Vasculaire, France.
EJVES Short Reports
|August 14, 2019
Summary
A rare case of expanded polytetrafluoroethylene (ePTFE) vascular graft disruption occurred in a 70-year-old man, leading to lower limb ischemia. Analysis revealed graft rupture at the external support ring, highlighting the need for failure mechanism examination.
Area of Science:
- Vascular Surgery
- Biomaterials Science
- Medical Device Failure Analysis
Background:
- Complete disruption of expanded polytetrafluoroethylene (ePTFE) vascular grafts is an uncommon complication.
- ePTFE grafts are frequently used for bypass procedures, including axillobifemoral bypasses.
Purpose of the Study:
- To report a rare case of ePTFE vascular graft disruption.
- To analyze the failure mechanism of a disrupted ePTFE graft.
Main Methods:
- Case report of a 70-year-old male patient.
- Clinical presentation of bilateral lower limb ischemia.
- Explant analysis of the disrupted ePTFE axillobifemoral bypass graft.
Main Results:
- The patient presented with Rutherford 2b lower limb ischemia two weeks after initial treatment for shoulder dislocation.
- A non-anastomotic pseudoaneurysm and complete graft disruption were identified.
- Explant analysis indicated rupture initiated at the ringed external support, with further tearing on the posterior wall at the same level.
Conclusions:
- Complete graft disruption, though rare, can occur in ePTFE vascular grafts.
- Failure analysis of the explanted graft revealed specific rupture points at the external support.
- Thorough investigation of failure mechanisms, even in isolated cases, is crucial for understanding and preventing vascular graft complications.
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