NOTESSymptomatic Sac Enlargement and Rupture due to Seroma after Open Abdominal Aortic Aneurysm Repair: Implications

We report 5 patients in whom a symptomatic perigraft seroma developed within the aortic sac, without vas-cular endoleak, after open repair of an abdominal aortic aneurysm (AAA) with polytetrafluoroethylene (PTFE) graft.1 We also discuss possible relationships of this phenomenon to endovascular repair of AAAs. Patients and Methods Over 18 years, 1,156 patients underwent repair of an AAA by one of the authors (B.M.B.). Of these, 1,084 underwent open repair, 256 with PTFE grafts. Five patients in the PTFE group (2.3%) returned at a mean of 4.5 years with acute abdominal or back pain and enlargement of the aortic sac. Mean diameter of the aneurysms was 5.9 cm preoperatively and 8.1 cm at readmission. There was no evidence of vascula