[Pseudoaneurysm after anastomosis of a prosthesis with the femoral artery].

Abstract

One of the complications of femoral artery synthetic prostheses are anastomotic aneurysms. In 1985-1993, 38 patients were treated for anastomotic aneurysms. Diagnosis was based on clinical and ultrasound examinations. A retrospective analysis has shown an occurrence of fever in 12 patients, and superficial pus oozing in 10 patients. Bacteriological cultures of intra-operatively collected specimens were positive in 25 patients. An infection with staphylococci was predominating. Repeated reconstructive surgery was performed within 6 months to 5 years after the primary one, mean 1.6 years. Aneurysm with the segment of prosthesis was excised and replaced by a fragment of new prosthesis (26 patients) or the vessel after excision of aneurysm was sutured with additional sutures on the whole anastomosis circumference (6 patients). On 7 patients bypass grafting was performed with ligation of vessels supplying anastomotic aneurysm. In all patients flow drainage was used. Positive result of re-operation was achieved in 21 (68.4%) patients. Limb was amputated in 10 cases (26.3%), and 2 patients (5.3%) died. An analysis of the treated patients showed an important role of the anastomotic infection in the anastomotic aneurysms formation. The treatment should include prolonged antibiotic therapy prior to the operation. In case of reoperation possible infection should always be considered.