Chronic Traumatic Pseudoaneurysm of Polytetrafluoroethylene Axillofemoral Bypass Graft in a Quadriplegic Patient

A case of nonanastomotic pseudoaneurysm of a polytetrafluoroethylene (PTFE) axillofemoral bypass graft due to chronic abrasion and pressure of the graft by external sources is reported. A quadriplegic patient presented with a pulsatile mass beneath his seatbelt straps in the mid-left chest region, consistent by computed tomography angiography and duplex ultrasound with a pseudoaneurysm of the PTFE graft, which had been placed 9 years previously. The patient underwent a successful endovascular repair of the pseudoaneurysm, and at 6-month follow-up the mass had resolved. To our knowledge this represents the first case of a chronic nonanastomotic pseudoaneurysm of a PTFE axillofemoral bypass graft secondary to abrasion and pressure that was repaired via an endovascular approach.