The Progression of Billowing of Endologix AFX2 Abdominal Aortic Aneurysm Device as a Precursor for the Rupture of an Abdominal Aortic Aneurysm.

Despite recent publications indicating billowing (aneurysmal degeneration of the outer fabric material manifesting as a bulging sac of contained contrast due to weakening of the fabric material between the metal struts) as a benign finding, we present a unique case of billowing that resulted in aneurysmal rupture with the AFX2 stent graft (Endologix, Inc., Irvine, CA). AFX2 consists of an inner metallic endoskeleton with multiple metallic struts covered by a polytetrafluoroethylene graft fabric.

Safety and efficacy of femoral-based hemodialysis access grafts.

Objective: Arteriovenous fistulae traditionally have been placed in the upper extremity. Experience with groin hemodialysis access has been discouraging because of high infection rates and associated limb amputation. We reviewed our experience with angioaccess grafts in the groin to assess safety and viability in our hemodialysis patient population.