Nonanastomotic Pseudoaneurysm With Complete Disruption of an Expanded Polytetrafluoroethylene Axillofemoral Bypass Graft

Rupture of an expanded polytetrafluoroethylene (ePTFE) vascular graft is rare. We report a nonanastomotic pseudoaneurysm associated with complete disruption of an ePTFE graft that occurred 6 years after an axillofemoral bypass. The 81-year-old patient had undergone neither trauma nor infection. The aneurysmal segment was resected, and a new ePTFE graft was interposed. The patient recovered uneventfully and was well 4 years later. Histologic analysis revealed a torn graft edge, consistent with a rupture due to excessive force, but scanning electron microscopy showed that the internal structure of the prosthesis was intact. The cause of the midgraft rupture remains unknown.