Print this pageSuccessful Treatment Of Hemodialysis Graft Seroma With A Covered Stent
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Nicholas J. Gargiulo, III, M.D., Frank Veith, M.D., Larry A. Scher, M.D., Evan C. Lipsitz, M.D., William D. Suggs, M.D., Evan Deutsch, M.D., Jeffrey Indes, M.D.
Albert Einstein College of Medicine, Bronx, NY, USA.
Prosthetic graft seromas are a rare complication that have been traditionally managed with open methods using partial graft replacement and open drainage. We report two cases of hemodialysis graft seromas successfully treated with a covered stent.
One patient is a 90 year old female who underwent right upper extremity grafting from the brachial artery to the axillary vein using a 4 to 7 mm tapered polyteterafluoroethylene (PTFE, Gore, Flagstaff, Arizona) graft. She developed a graft seroma one month following placement of the graft and was unsuccessfully managed with both percutaneous and open drainage of the seroma. A 8mm x 50mm Wallgraft (Boston Scientific, Mass.) was percutaneously deployed in the most proximal arterial portion of the graft. The seroma completely resolved at 2 weeks and the graft was successfully accessed for hemodialysis at one month. The hemodialysis graft has remained patent for 8 months and has been functioning well without any recurrence of the seroma.
The other patient is a 62 year old female who also underwent left upper extremity grafting from the brachial artery to the axillary vein with a PTFE graft. She developed a graft seroma and was managed successfully with open drainage and placement of a #7 JP drain. Six weeks following removal of the drain the seroma recurred. A 8 mm x 50mm Wallgraft was also deployed in the most proximal arterial portion of the graft resulting in successful treatment of the seroma. The hemodialysis graft has remained patent for 10 months without seroma recurrence.
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