CASE REPORTS   

International Angiology 2001 September;20(3):248-50

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

Non-anastomotic midgrafts stenosis of a knitted Dacron graft after arterial reconstruction. Report of a case

Shigematsu K. ¹, Shigematsu H. ¹, Nishikage S. ^{1, 2}, Origuchi N. ³, Ishikawa I. ², Furuta Y. ²

From the 1 Division of Vascular Surgery, Department of Surgery, University of Tokyo, Tokyo, Japan 2 Department of Surgery, Social Insurance Gunma Central General Hospital, Gunma, Japan 3 Department of Surgery, Tokyo Senbai Hospital, Tokyo, Japan

Midgraft sten­o­sis of the pros­the­sis after ­bypass sur­gery has sel­dom been report­ed. A man pre­sent­ed with an ischem­ic ulcer of the left foot. He had under­gone bilat­er­al femor­o­pop­li­teal ­bypass sur­gery as well as left-sided ili­of­e­mo­ral ­bypass sur­gery with a knit­ted Dacron graft. The graft in his left thigh was occlud­ed. A knit­ted Dacron con­duit with 8-mm diam­e­ter was inter­posed ­between the ili­of­e­mo­ral ­bypass graft and the left pro­fun­da fem­or­is ­artery, and graft-pop­li­teal jump­ing ­bypass sur­gery was added. The post­op­er­a­tive angio­gram ­showed a short-seg­men­tal ­severe sten­o­sis of the inter­posed graft neigh­bor­ing the prox­i­mal anas­tom­o­sis. Repeat sur­gery ­showed that the ste­not­ic ­lesion was locat­ed sep­ar­ate­ly from the anas­tom­o­sis. This mid­graft sten­o­sis was con­sid­ered to con­sist of dis­sec­tion of pseu­do­in­ti­ma asso­ciat­ed with the intra­op­er­a­tive pro­ce­dures. In cases of ­repeat sur­gery ­around the ingui­nal lig­a­ment, pro­ce­dures ­should be per­formed with great care.