Abstract
Material defects, both in grafts and sutures, are important contributing factors to the formation of an anastomotic aneurysm. With the advent of modern polypropylene monofilament suture, primary failures have become uncommon. However, we have used monofilament polyamide sutures prior to the use of polypropylene suture. We report a case of anastomotic aneurysm occurring due to fragmentation of a monofilament polyamide suture. A 75-year-old man had undergone open surgical repair of an abdominal aortic aneurysm 15 years previously. He was referred to our hospital with profound hemorrhagic shock and underwent emergency surgery: it revealed a pseudoaneurysm rupture due to the extravasation of blood in the fibrous capsule surrounding the vascular prosthesis. Half the proximal aortic suture line and the entire distal aortic suture line were disrupted. We removed the fragment of the degraded suture and analyzed it in detail. Based on this analysis, it was concluded that deterioration of the monofilament polyamide suture was the primary cause of anastomotic aneurysm rupture.
