Experience with covered stents for the management of hemodialysis polytetrafluoroethylene graft seromas
Received 20 November 2007; accepted 23 January 2008.
Prosthetic graft seromas is a rare complication that has been traditionally managed with open methods using partial graft replacement and open drainage. We report the first two cases of hemodialysis graft seromas successfully treated with a covered stent. Both patients underwent arteriovenous graft placement from the brachial artery to the axillary vein using a standard wall, tapered 4 to 7 mm polytetrafluoroethylene graft, but developed a seroma at the arterial end of the graft. Unsuccessful attempts were made to treat these seromas with percutaneous and open drainage. In both patients, an 8 mm × 50 mm Wallgraft (Boston Scientific, Natick, Mass) was retrogradely deployed “bareback” at the arterial end of the graft allowing for complete resolution of the graft seromas.
aDivision of Vascular Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
bCleveland Clinic Foundation/New York University School of Medicine, New York, NY.
Reprint requests: Nicholas J. Gargiulo III, MD, Montefiore Medical Center and the Albert Einstein College of Medicine, Division of Vascular Surgery, MAP 4, Bronx, NY 10467.