International Journal of Angiology

, Volume 4, Issue 4, pp 208–211 | Cite as

Incorporation failure of dacron arterial grafts

  • Giuseppe Cardia
  • Domenico Argentiero
  • Salvatore Rizzo
  • Guido Regina
Original Articles
  • 19 Downloads

Abstract

Two cases of impaired Dacron arterial graft incorporation are reported. They were characterized by the presence of an inflammatory reaction with periprosthetic collection rich in cells but with no detectable germs. The patients also showed total lack of systemic symptoms, including humoral signs of altered immune response, and the tendency of well-tolerated external discharge from the collection. Based on these data and on the body's behavior towards a small fragment of the same type of alloplastic material implanted subcutaneously in the forearm of one of these patients, this phenomenon has been interpreted as an intolerance to the graft material, similar to a generic foreign body reaction rather than an immunologic reaction. We think it is extremely important to differentiate this kind of aseptic graft intolerance from graft infections before deciding on adequate treatment. Moreover, our experience and that of other similar cases, collected from the literature, led us to suspect that many cases that are labeled as low-grade infections could not really be infections. The results reported here justify the need to distinguish between infections and intolerance to the graft material.

Keywords

Immune Response Foreign Body Inflammatory Reaction Similar Case Small Fragment 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Wesolowski SA, Fries CC, Hennigar G, Fox LM, Sawyer PN, Sauvage LR (1964) Factors contributing to long-term failures in human vascular prosthetic grafts. J Cardiovasc Surg 5:544–567.Google Scholar
  2. 2.
    Blumemberg RM, Gelfand ML, Dale WA (1985) Perigraft seromas complicating arterial grafts. Surgery 97:194–203.PubMedGoogle Scholar
  3. 3.
    Buche M, Schoevaerdts JC, Jaumin P, Poulot R, Chalant CH (1986) Séromes périprosthétiques après pontage axillo-fémoral: À propos de trois cas. Ann Chir Vasc 1:374–377.Google Scholar
  4. 4.
    Rhodes VJ (1986) Perigraft seroma: Simple solution to a difficult problem. J Vasc Surg 3:939.PubMedGoogle Scholar
  5. 5.
    Lowery RC Jr, Wicker HS, Sanders K, Peniston RL (1987) Management of a recalcitrant periprosthetic fluid collection. J Vasc Surg 6:77–80.PubMedGoogle Scholar
  6. 6.
    Kaupp HA, Matulewicz TJ, Lattimer GI, Kremen JC, Celani VJ (1979) Graft infection or graft reaction? Arch Surg 114:1419–1422.PubMedGoogle Scholar
  7. 7.
    Schaefer CS, Giordano JM (1981) Reaction to Dacron velour bypass graft. Vasc Surg 15:114–116.Google Scholar
  8. 8.
    Bhuta I, Dorrough R (1981) Noninfectious fluid collection around velour Dacron. Possible allergic reaction. South Med J 74:870.PubMedGoogle Scholar
  9. 9.
    Piccone VA (1987) Infected prosthetic vascular grafts: Literature review. In: Modern Vascular Grafts, Sawyer PN (ed). Mc-Graw-Hill: New York.Google Scholar
  10. 10.
    Jacobs MJHM, Reul GI, Gregoric I, Cooley DA (1991) In situ replacement and extra-anatomic by-pass for the treatment of infected abdominal aortic grafts. Eur J Vasc Surg 5:83–86.PubMedGoogle Scholar
  11. 11.
    Hayward RH, Korompai FL (1976) Degeneration of knitted Dacron grafts. Surgery 79:581–583.PubMedGoogle Scholar
  12. 12.
    Vollmar JF, Hesse G, Mohr W (1983) Biological intolerance of vascular prostheses. J Cardiovasc Surg 24:311.Google Scholar
  13. 13.
    Szilagyi DE (1979) Graft infection or graft reaction? Arch Surg 114:1422.Google Scholar
  14. 14.
    Sladen JG, Manal MAJ, Grossman LG, Denegri JF (1985) Fibroblast inhibition: A new treatable cause of prosthetic graftfailure. Am J Surg 149:587–590.PubMedGoogle Scholar
  15. 15.
    Ahn SS, Machleder HJ, Gupta I, Moore WS (1987) Perigraft seroma: Clinical, histologic and serologic correlates. Am J Surg 154:173–178.PubMedGoogle Scholar
  16. 16.
    Thomas WEG, Baird RN (1986) Secondary aorto-enteric fistulae: Toward a more conservative approach. Br J Surg 73:875–878.PubMedGoogle Scholar
  17. 17.
    Walker WE, Cooley DA, Duncan JM, Hallman GL, Ott DA, Reul GJ (1987) The management of aorto-duodenal fistula by in situ replacement of the infected abdominal aortic graft. Ann Surg 204:727–732.Google Scholar
  18. 18.
    Robinson JA, Johansen K (1991) Aortic sepsis: Is there a role for in situ graft reconstruction? Am J Vasc Surg 13:677–684.Google Scholar

Copyright information

© International College of Angiology, Inc. 1995

Authors and Affiliations

  • Giuseppe Cardia
    • 1
  • Domenico Argentiero
    • 2
  • Salvatore Rizzo
    • 3
  • Guido Regina
    • 3
  1. 1.Istituto di Chirurgia d'UrgenzaUniversità di BariItaly
  2. 2.Servizio di Pronto SoccorsoOspedale MiulliAcquaviva (Ba)
  3. 3.Cattedra di Chirurgia VascolareUniversità di BariBariItaly

Personalised recommendations