Spontaneous vein graft rupture after infrainguinal vascular reconstruction: report of three cases.

We report three cases of spontaneous vein graft rupture within 2 weeks of infrainguinal vein bypass for limb salvage. Two of the three ruptures were in the distal vein graft and the last just beyond the proximal anastomosis. All were longitudinal slits in the vein with no proximity to branches or valves. Endovascular treatment failed in one patient. Surgical correction with graft salvage was possible in all three cases. This may be an ischemic injury analogous to carotid vein patch rupture, nonapparent trauma to the vein, or simply mechanical stress causing vein rupture with arterial flow.