Early detection and differentiation of periprosthetic fluid accumulation after vascular reconstructive surgery.

Ultrasonographic duplex scanning is used widely to screen the abdominal arterial system and to detect lesions in the extracranial cerebral arteries. Based on clinical studies of 11,712 vascular reconstructions, this report describes the early recognition of fluid accumulation around vascular prostheses. The clinical examination may suggest the typical complications that arise after vascular surgery such as hematoma, pseudoaneurysm, lymphocele, abscess, or perigraft cyst. Duplex scanning, combined with puncture and aspiration, proved to be of great benefit in differentiating the specific type and extent of the complication. Special attention is paid to the so-called perigraft reaction, thought to be a result of an aseptic biological incompatibility to synthetic vascular grafts. It is emphasized that ultrasonographic routine follow-up after vascular surgery is essential for early diagnosis, especially since each complication suspected requires specific therapeutic treatment to prevent exacerbation because of inadequate treatment.