Polyester graft dilatation in a patient operated for a ruptured abdominal aortic aneurysm — case report and literature review

A polyester graft dilatation is a rare complication after reconstructive surgery on blood vessels. The mechanism underlying it remains unclear while the procedures to follow in such cases have not been definitely established. The article presents the case of a 68-year old man who was operated in 2008 for a ruptured abdominal aortic aneurysm and in whose case the aortic graft diameter doubled subsequently. Admitted to hospital in a critical general condition, the patient underwent an emergency surgery. A classic laparotomy was performed and the abdominal aorta was reconstructed using a straight polyester graft (InterGard Knitted). The surgery itself was uncomplicated, nor were any complications registered during the postoperative treatment in the Intensive Care Unit and in the General Surgery Ward. The patient was discharged in a good general condition, without neurological deficits, with both the dorsalis pedis and the posterior tibial arterial pulses palpable in both feet. The patient remains in the care of the Surgical Outpatient Department. The postoperative follow-up over a number of years has revealed a continuous gradual dilatation of the vascular graft diameter. The regularly repeated scans (ultrasonography, angiotomography) detected a recurrence of aneurysm-like dilatation where the aorta had been reconstructed. The patient is in a good general condition and does not report any ailments. A physical examination has revealed no alarming symptoms. Based on collected literature, the conclusions of the present article briefly discuss the possible reasons for the afore-discussed complications and make suggestions as to the procedures to be followed in such cases.