Validation of Duplex Ultrasound Graft Surveillance in the Immediate Postoperative Period

A femoral crossover polytetrafluoroethylene graft was performed in a patient immediately, after a failed iliac endograft limb recanalization, performed 2 years after endovascular aortic aneurysm repair. Although graft patency was confirmed clinically by palpation of groin pulses as well as noninvasively by segmental pressure measurements and Doppler examination, in the immediate postoperative period, duplex ultrasound failed to show any blood flow inside the graft lumen until the fourth postoperative day. Subcutaneous air and air tapped within the wall structure of the graft are possible explanation for the failure to show flow.