Endovascular relining of a Dacron graft for refractory perigraft seroma

Although perigraft seroma (PGS) is a well-known complication of vascular surgery, optimal therapy has not yet been established. A 90-year-old patient underwent a bypass from the right subclavian artery to the left carotid and subclavian arteries for debranching thoracic endovascular aortic repair. Four years post-surgery, computed tomography revealed PGS at the anastomosis site. Percutaneous needle aspiration and surgical drainage were ineffective in treating PGS. We performed a relining procedure using covered stents for the bypass graft that resolved the PGS. This procedure is minimally invasive, avoids graft excision, and can be especially valuable for elderly patients.