Clinical analysis of non-anastomotic aneurysms of implanted prosthetic grafts

Abstract

Purpose: To investigate the features of non-anastomotic aneurysms (NAAs) of implanted prosthetic grafts through our case series and present a general review of NAAs.

Methods: We studied retrospectively, a series of NAAs of seven grafts in six patients treated between 2001 and 2010, and reviewed the data on NAAs reported between 1962 and 2009.

Results: The grafts in our series were implanted between 1986 and 2006. The primary surgical procedures were bypass between the axillary and femoral artery (n = 1), bypass between the subclavian artery and abdominal aorta (n = 1), bypass between the aorta and femoral artery (n = 1), bypass between the femoral and popliteal artery (n = 1), bypass between the femoral and femoral artery (n = 2), and bypass between the aorta and iliac artery (n = 1). The graft material was knitted Dacron in all cases and the implantation period ranged from 2.7 to 24 years (median 13.8 years). All NAAs originated from a hole in the graft. Reports of NAA have decreased dramatically, although according to the data, knitted Dacron accounted for 80 % of these implanted grafts.

Conclusions: Graft deterioration and the subsequent development of an NAA can occur even with the latest knitted Dacron grafts, even though the incidence is very low.