CASE REPORT: Axilla False Aneurysm Following Late Anastomotic Disruption of an Old Axillofemoral Bypass Graft

Introduction was placed more proximal on the axillary artery. The distal anastomosis was made to incorporate the distal Daar and Finch first described anastomotic disruption portion of the old graft. At the time of her most recent presentation, 10 of the axillary end of an axillofemoral graft in 1978. Since then there have been few reports of false anyears after her second right axillofemoral bypass, an angiogram and a CT scan (Fig. 1) both showed an eurysm at this site, and each case usually presents within a few weeks of surgery. An unusual case aneurysm (later shown to be a false aneurysm) along the course of the original right axillofemoral graft. At of delayed disruption of the proximal anastomosis presenting as an axilla swelling 18 years after the surgery, through the old incision, it was apparent that the original axillofemoral graft had become completely original axillofemoral bypass surgery is described. detached from the axillary artery, with the intervening tract dilated to form a false aneurysm, the wall being formed by the still intact fibrous sheath that had Case Report covered the Dacron graft following implantation. The suture material was still intact and attached around A 70-year-old lady who had been reviewed annually the graft. As a consequence of the graft migration and in a vascular clinic presented with worsening clautraction on the axillary artery, it was possible to identify dication in her right calf. Incidentally, a 7 cm by 6 cm the artery early in the dissection allowing proximal pulsatile mass was noticed at the level of the nipple in the right axilla. This was not painful and she had noticed the mass 6 months previously, since when it has steadily grown in size. Eighteen years previously she had bilateral axillofemoral Dacron grafts inserted for the management of an infected aortobi-iliac graft (removed at the same time). Eight years after this her right axillofemoral graft thrombosed and at the same time she was diagnosed with caecal carcinoma. She had a left to right femoro-femoral bypass which improved the circulation to the right leg, followed simultaneously by a right hemicolectomy. The cross-over graft later thrombosed and a new right axillofemoral Dacron graft was performed, this time the anastomosis