title: Localized argyria caused by metallic silver aortic grafts: a unique adverse effect.
abstract: BACKGROUND
  Silver-coated grafts are designed to prevent vascular graft infections. Silver is a safe element but toxic effects have been reported. We describe two cases of possible localized argyria after silver graft implantation.
  
  
  METHODS
  Two patients presented with perigraft groin collections after implantation of silver grafts. During reoperation, an ashen-grey necrotic substance was seen surrounding the grafts. The grafts were explanted and lower limb perfusion restored. Cultures were negative and both patients had uneventful recoveries.
  
  
  CONCLUSIONS
  Our cases are highly suggestive of a possible unique adverse effect: a combination of localized silver toxicity and neutrophilic mediated tissue destruction.
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: p.berger@umcutrecht.nl.
authors.forename: P
authors.initials: P
authors.lastname: Berger
authors.forename: J B
authors.initials: JB
authors.lastname: Ricco
authors.forename: P
authors.initials: P
authors.lastname: Liqui Lung
authors.forename: F L
authors.initials: FL
authors.lastname: Moll
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery*; D001129:Argyria / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D020878:Device Removal; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012086:Reoperation; D012834:Silver / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D012834:Silver
keywords: Adverse effect; Argyria; Silver grafts