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Management of aneurysm sac hygroma

Risberg, B; Delle, M; Lonn, L and Syk, Ingvar LU (2004) In Journal of Endovascular Therapy 11(2). p.191-195
Abstract
Purpose: To document the management strategies and outcome of patients diagnosed with sac hygroma following open or endovascular abdominal aortic aneurysm (AAA) repair. Methods: Seven men (median 68 years, range 43-79) with previous open (n=3) or endovascular (n=4) AAA repairs and increasing aneurysm diameters documented on spiral computed tomography (CT) were diagnosed with sac hygroma based on the lack of a demonstrable endoleak on CT imaging; the presence of a gelatinous, clear fluid in the sac; and a nonpulsatile sac pressure that was about one third of the systemic blood pressure. The patients were followed at regular intervals with spiral CT and percutaneous CT-guided translumbar intrasac pressure measurements. Surgical interventions... (More)
Purpose: To document the management strategies and outcome of patients diagnosed with sac hygroma following open or endovascular abdominal aortic aneurysm (AAA) repair. Methods: Seven men (median 68 years, range 43-79) with previous open (n=3) or endovascular (n=4) AAA repairs and increasing aneurysm diameters documented on spiral computed tomography (CT) were diagnosed with sac hygroma based on the lack of a demonstrable endoleak on CT imaging; the presence of a gelatinous, clear fluid in the sac; and a nonpulsatile sac pressure that was about one third of the systemic blood pressure. The patients were followed at regular intervals with spiral CT and percutaneous CT-guided translumbar intrasac pressure measurements. Surgical interventions were performed for sac diameter increase >5 mm or expansion-related pain. Blood samples and fluid aspirated from the sac were analyzed to detect activation of the coagulation and fibrinolytic systems. Results: Over a median 21.5-month follow-up, open fenestration with resection of the aneurysm wall or open tight wrapping of the wall around the graft in 4 patients did not prevent hygroma reoccurrence, nor did repeated punctures with aspiration of fluid in the other 3 patients. Aneurysm diameters remained unchanged during the observation period. Conclusions: Only symptomatic hygromas need be treated, but the treatment of choice remains to be established, since puncture, fenestration, or resection of the sac do not seem to be adequate. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
abdominal aortic aneurysm, enclovascular repair, open repair, stent-graft, aneurysm expansion, hygroma, polytetrafluoroethylene, graft, Dacron graft
in
Journal of Endovascular Therapy
volume
11
issue
2
pages
191 - 195
publisher
International Society of Endovascular Specialists
external identifiers
  • wos:000220771800016
  • pmid:15056031
  • scopus:1842631489
ISSN
1545-1550
DOI
10.1583/03-1059.1
language
English
LU publication?
yes
id
1210e0c7-7cc0-4784-9e0d-378b9694334d (old id 899100)
date added to LUP
2008-01-18 11:29:27
date last changed
2017-12-10 03:46:54
@article{1210e0c7-7cc0-4784-9e0d-378b9694334d,
  abstract     = {Purpose: To document the management strategies and outcome of patients diagnosed with sac hygroma following open or endovascular abdominal aortic aneurysm (AAA) repair. Methods: Seven men (median 68 years, range 43-79) with previous open (n=3) or endovascular (n=4) AAA repairs and increasing aneurysm diameters documented on spiral computed tomography (CT) were diagnosed with sac hygroma based on the lack of a demonstrable endoleak on CT imaging; the presence of a gelatinous, clear fluid in the sac; and a nonpulsatile sac pressure that was about one third of the systemic blood pressure. The patients were followed at regular intervals with spiral CT and percutaneous CT-guided translumbar intrasac pressure measurements. Surgical interventions were performed for sac diameter increase >5 mm or expansion-related pain. Blood samples and fluid aspirated from the sac were analyzed to detect activation of the coagulation and fibrinolytic systems. Results: Over a median 21.5-month follow-up, open fenestration with resection of the aneurysm wall or open tight wrapping of the wall around the graft in 4 patients did not prevent hygroma reoccurrence, nor did repeated punctures with aspiration of fluid in the other 3 patients. Aneurysm diameters remained unchanged during the observation period. Conclusions: Only symptomatic hygromas need be treated, but the treatment of choice remains to be established, since puncture, fenestration, or resection of the sac do not seem to be adequate.},
  author       = {Risberg, B and Delle, M and Lonn, L and Syk, Ingvar},
  issn         = {1545-1550},
  keyword      = {abdominal aortic aneurysm,enclovascular repair,open repair,stent-graft,aneurysm expansion,hygroma,polytetrafluoroethylene,graft,Dacron graft},
  language     = {eng},
  number       = {2},
  pages        = {191--195},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Therapy},
  title        = {Management of aneurysm sac hygroma},
  url          = {http://dx.doi.org/10.1583/03-1059.1},
  volume       = {11},
  year         = {2004},
}