Computerized tomographic assessment of graft incorporation after aortic reconstruction

Computerized tomographic scanning is being used with increasing frequency for the detection of abdominal aortic prosthetic complications. Although computerized tomography remains a very precise method for direct imaging of the retroperitoneal space, the interpretation of a postoperative computerized tomographic scan is limited by the absence of any information on the normal appearance of the routine uncomplicated aortic graft. To study the normal tissue incorporation of aortic grafts, 29 patients were evaluated with periodic postoperative computerized tomographic scans. Seventeen patients had aortoiliac occlusive disease and 12 had aneurysmal disease. No patients who had reoperation were included and all patients had a normal postoperative course. Computerized tomographic scans were obtained in the early (mean 7 days), intermediate (mean 48 days), and late (mean 102 days) postoperative periods. A variable amount of perigraft hematoma was always present on the initial computerized tomographic scan. Perigraft air was seen in only four patients in the early study. Graft incorporation appeared complete in these patients by 48 days, although minimal hematoma persisted in one patient. This study provides baseline data on the appearance and timing of aortic graft incorporation which should facilitate subsequent computerized tomographic detection of aortic graft complications.