Fig. 1 -A,
Right extemal
iliac angiogram.
Occlusion
of proximal
part of
valve and partially obstructs
saphenous
area of bypass graft. C, Mild extrava-
Gore-Tex
graft
stump
cl saphenous
bypass graft. B, Portable
arteriogram.
sation
(arrow)
from medial wall of graft stump.
Large
thrombus
(arrow) within distal Gore-Tex graft stump. Stump acts as ball
Received May 31
. 1983; accepted after revision May 4, 1984.
I Department
of Radiology,
St. James Hospital,
1423 Chicago Rd., Chicago Heights.
IL 6041 1 . Address
reprint
requests
to N. H. Rosner.
2 Department
of Radiology,
University of Chicago Hospital
and Clinics, Chicago,
IL 60637.
633
AJR
143:633-684,
September
1984 0361-803X/84/1433-0633
C American
Roentgen Ray Society
Contrast
Extravasation
through
a Gore-Tex
Graft:
A
Sequela
of Low-Dose
Streptokinase
Therapy
Neal
H. Rosner’
and Peter
E.
2
Within
the
last
few
years,
low-dose
intraarterial
streptoki-
nase
infusion
has
proven
an extremely
useful
therapy
for
acute
arterial
occlusion
[1 -3].
Contrast
extravasation
through
the
interstices
of knitted
Dacron
grafts
has been documented
during
streptokinase
infusion
[4].
Contrast
extravasation
through
a Gore-Tex
graft
(polytetrafluorethylene,
W. L. Gore
& Assoc.)
has
been
ently
reported
[5].
We
describe
a
similar
case
of asymptomatic
contrast
extravasation
through
the proximal
stump
of a Gore-Tex
graft.
Case Report
A 67-year-old
diabetic
man had a long history
of severe
peripheral
vascular
disease. One year before admission,
he underwent
a right
femoropopliteal
Gore-Tex
bypass
graft,
which
occluded
after
several
months.
During
the first
of
two subsequent
admissions,
he had early
gangrenous
changes
of
the
right
first
and
second
toes.
A
right
femoroanterior
tibial autologous
vein bypass
graft was performed
in
an attempt
to salvage
the
limb.
The proximal
part
of
the vein
graft
was anastomosed
in an end-to-end
fashion
to
the stump
of
the
occluded
Gore-Tex
graft.
The distal
end of
the vein graft
was
anas-
tomosed
to the anterior
tibial artery. The patient
underwent
amputa-
t