Relapsing seroma in a uremic patient bearing a PTFE graft as vascular access

• Published in: The journal of vascular access 2001-01, Vol.2 (1), p.28-31
• Main Authors: Allaria, P M, Lucatello, A, Gandini, E, Giangrande, A
• Format: Article
• Language: English
• ISSN: 1129-7298; 1724-6032
• DOI: 10.1177/112972980100200106

Seroma is one of the most frequent complications of PTFE vascular grafts and its etiology is still unclear. A 51 year-old male on regular dialytic treatment for seven years underwent the surgical implantation of a vascular prosthesis of homologous safena due to the thrombosis of his native artero-venous fistula. Several years earlier the patient had suffered the amputation of the left forearm because of electric shock. A few months later the vascular prosthesis was replaced with a PTFE vascular graft as a result of aneurysm formation and thrombosis. During the following days a non pulsating swelling occurred near the arterial anasto-mosis. Ultrasonography, doppler sonography and aspiration confirmed the diagnosis of seroma and it was surgically removed. Some weeks later a new seroma was observed in the same site and associated with a skin ulcer. A new surgical removal had no benefit and about one month later a perigraft collection was found along with signs of bacterial infection. For this reason the patient underwent the surgical excision of the PTFE graft and a vascular access was warranted by placing a Tesio TM catheter. Usually surgery is considered mandatory in seromas larger than 2 cm in diameter and showing continuous growth. In our patient the poor vascular status might have suggested a more conservative management even with a seroma diameter of about 7 cm. Nevertheless the high risk of systemic infection prompted us to remove the PTFE graft.