A novel approach to the management of a recurrent lymphocele following a femoral-femoral bypass.

Abstract

An 86-year-old man presented with a recurrent groin lymphocele following endovascular abdominal aortic aneurysm repair using an aorto-uni-iliac reconstruction with polytetrafluoroethylene femoral-femoral crossover. Following this procedure, the patient developed a groin lymphocele. This fluid collection was treated with multiple aspirations and subsequent groin exploration with lymphatic ligation. Despite ligation, the fluid collection returned. Given these recurrences, replacement of the polytetrafluoroethylene graft with Dacron was performed. After graft replacement, the lymphocele recurred. A lymphangiogram was then performed by directly injecting the lymphocele, identifying the culprit lymphatic channels allowing N-butyl cyanoacrylate injection to seal the source of lymphatic drainage. No reappearance of the lymphocele was observed.