# Traumatic injury to vascular prosthetic anastomosis: A case report and diagnostic approach

## TL;DR

A rare case of traumatic injury to a vascular prosthesis anastomosis leading to a pseudoaneurysm is reported, highlighting the importance of diagnosis and treatment.

## Contribution

This case report highlights the rare occurrence of traumatic injury to a prosthesis-to-prosthesis anastomosis and its successful treatment.

## Key findings

- Traumatic injury to a prosthesis-to-prosthesis anastomosis can lead to a leak and pseudoaneurysm formation.
- Late prosthesis-prosthesis anastomosis tear caused by a traumatic event is rare.
- Ultrasound and CT are considered gold standard for diagnosing pseudoaneurysms.

## Abstract

Traumatic injury of a vascular prosthesis-to-prosthesis anastomosis leading to an extravasation and pseudoaneurysm is rare. If not identified the complications associated with this condition can lead to high morbidity and mortality and require surgical treatment.

We describe a patient who presented with a tear in prosthesis-prosthesis anastomosis eight years after implantation resulting in a pseudoaneurysm. The patient had a severe fall prior to the non-symptomatic leakage. The complication was successfully treated by re-lining the graft with a new anastomosis at the Department of Vascular and Endovascular Surgery, Kolding Hospital in Denmark.

Cause of tear is speculated to be due to weakness at site of reconstruction, fabric degradation, and/or degradation of suture material.

Late prosthesis-prosthesis anastomosis tear caused by a traumatic event is rare. In the event of a late tear, anamnesis and histological analysis of involved material is important.

•Traumatic injury to a prosthesis-to-prosthesis anastomosis can lead to a leak and pseudoaneurysm formation.•Leakage can be asymptomatic, making it potentially lethal to limb and life.•UL and CT are considered gold standard for the diagnosis of a pseudoaneurysm.

Traumatic injury to a prosthesis-to-prosthesis anastomosis can lead to a leak and pseudoaneurysm formation.

Leakage can be asymptomatic, making it potentially lethal to limb and life.

UL and CT are considered gold standard for the diagnosis of a pseudoaneurysm.