The aortofemoral graft: detection and identification of healing complications by ultrasonography

Abstract

Although accepted as an accurate method for determining the size of abdominal aortic aneurysms, the value of gray-scale ultrasound in other aspects of peripheral vascular disease is less well defined. Therefore, we studied 87 patients with are aortofemoral grafts using B-scan and real-time scanners to determine the efficacy of these techniques in the detection of healing complications. Sonography delineated the proximal anastomosis in 84%, the iliac graft limbs in 88% to 91%, and the distal anastomosis in all but one instance. Sixty-six abnormalities, most clinically unsuspected, were identified. Of these, anastomotic femoral and aortic false aneurysms were most common. Ultrasound also identified perigraft fluid collections secondary to hematoma, seroma, and infection that were not detected by angiography. Ultrasound is relatively inexpensive, atraumatic, and without radiation hazard. It is recommended as the initial method for evaluating suspected healing complications of arterial grafting and as a means of long-term follow-up of patients with aortofemoral grafts.