Transverse rupture of ring-supported Dacron graft 10 years after axillobifemoral artery bypass: induced by graft deterioration and Fogarty thrombectomy.

A 70-year-old woman underwent an axillobifemoral artery bypass using a bifurcated ring-supported Dacron graft in 2004 and then noticed a pulsatile mass in the left flank 10 years later. A Fogarty thrombectomy was performed for acute graft occlusion. Eight months later, computed tomography revealed pseudoaneurysm formation in the graft body and surgical graft interposition was performed. The operative findings showed a transverse rupture of the graft just above the bifurcation. Histological findings revealed graft deterioration with filaments broken off from the graft. Although the cause of pseudoaneurysm formation was not apparent, the combination of graft deterioration and additional damage from the Fogarty thrombectomy was highly suspicious.