Metachronous multiple non-anastomotic aneurysms in a bifurcated double velour knitted Dacron graft

A case of metachronous non-anastomotic aneurysms in a bifurcated double velour knitted Dacron aorto-bifemoral graft is reported. The cause of non-anastomotic graft aneurysms is most likely due to a basic structural failure in the graft, as a result of defects in fabrication, Dacron fibre deterioration or a combination of both. Local excision of the graft defect with interposition graft replacement is an accepted treatment for local graft failure. However, as fabrication defects and Dacron fibre deterioration are both factors affecting the whole graft, it is not surprising to find multiple aneurysms in the same graft synchronously or metachronously. Thus, a total graft replacement should be the treatment of choice for graft failure.