Sonography of axillofemoral and femorofemoral subcutaneous arterial bypass grafts.

Axillofemoral and femorofemoral grafts in 12 patients were examined on 22 occasions with linear-array and digital static scanners with 5-MHz transducers and a 10-MHz high-resolution real-time instrument. Real-time instruments that produce a linear image, particularly high-resolution small-parts units, are the most appropriate to define the incorporation of the prosthesis, its pulsatility, and the nature of the perigraft bed. Early after implantation, these grafts have small perigraft fluid collections in the surgically created tunnels. These collections disappear spontaneously as the graft is incorporated into the tissues. However, discrete and persistent perigraft fluid collections are abnormal. Such collections were noted in five patients. One proved to be abscess and four were seromas. Graft occlusions (four patients) and an anastomotic aneurysm (one patient) were also readily diagnosed on sonography.