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Case Reports
. 2024 Oct:123:110239.
doi: 10.1016/j.ijscr.2024.110239. Epub 2024 Sep 5.

Traumatic injury to vascular prosthetic anastomosis: A case report and diagnostic approach

Nulvin Djebbara-Bozo  1 , Emilie Arntoft Pedersen  2 , Maria Arvad Serifi  2 , Christian Nikolaj Petersen  3
Affiliations
Case Reports

Traumatic injury to vascular prosthetic anastomosis: A case report and diagnostic approach

Nulvin Djebbara-Bozo et al. Int J Surg Case Rep. 2024 Oct.

Abstract

Introduction: Traumatic injury of a vascular prosthesis-to-prosthesis anastomosis leading to an extravasation and pseudoaneurysm is rare. If not identified the complications associated with this condition can lead to high morbidity and mortality and require surgical treatment.

Case: We describe a patient who presented with a tear in prosthesis-prosthesis anastomosis eight years after implantation resulting in a pseudoaneurysm. The patient had a severe fall prior to the non-symptomatic leakage. The complication was successfully treated by re-lining the graft with a new anastomosis at the Department of Vascular and Endovascular Surgery, Kolding Hospital in Denmark.

Discussion: Cause of tear is speculated to be due to weakness at site of reconstruction, fabric degradation, and/or degradation of suture material.

Conclusion: Late prosthesis-prosthesis anastomosis tear caused by a traumatic event is rare. In the event of a late tear, anamnesis and histological analysis of involved material is important.

Keywords: Case report; Prosthesis; Pseudoaneurysm; Traumatic; Vascular.

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Conflict of interest statement

Declaration of competing interest No conflict of interest.

Figures

Fig. 1
Fig. 1
A and B: CT-angiography in axial and coronal plane, with Multiplanar Reconstruction (MPR) showing pseudoaneurysm forming in the anastomosis site between an axillofemoral bypass and fem-fem bypass. C and D: CT-angiography in arterial phase (axial plane), showing contrast extravasation from the defect of the posterior part of the prosthesis, causing the pseudoaneurysm.
Fig. 2
Fig. 2
A and B: 3D reconstruction in coronal and axial. B clarifies the defect in the prosthesis with contrast extraversion.
Fig. 3
Fig. 3
A and B: Respectively show US with Doppler-flow and B-mode images, revealing the defect in the prosthesis. B-flow mode focuses is designed to display the movement of blood as it flows through the vessel in a dynamic manner. It enhances the contrast between blood and surrounding tissue, enabling improved visualization of blood flow patterns and detection of abnormalities.
See this image and copyright information in PMC

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