Anastomotic Aneurysms in the Groin - Results of Surgical Treatment

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Anastomotic Aneurysms in the Groin - Results of Surgical Treatment

The aim of the study. The authors introduce single-center results of surgical treatment of 84 aneurysms in 79 patients. Anastomotic aneurysms belong to group of pseudoaneurysms which appear in places after vascular anastomosis.

The most common location of this kind of pseudoaneurysm is the groin (85%). The next most common location is the proximal anastomotic place with the aorta or iliac common artery (12%), which constitutes from 1 to 5% of all vascular abnormalities. Usually, these need to be surgically treated.

Material and methods. The authors present surgical treatment results of 79 patients with 84 pseudoaneurysms: 10 women (12.7%) and 69 men (87.3%) ranging in age from 44 to 81 years old, with an average age of 64.7 years old.

The frequency of this pathology in all patients with vascular diseases treated in our Department was 1.6% and 7.7% in patients after surgical anastomosis in the groin. Eleven patients (13.9%) with aneurysm rupture and four (5.1%) with thrombosis and acute ischemia of the lower limb needed an emergency operation. The remaining 64 patients (81%) were operated on according to the plan.

The most common operations were: vascular by - pass, secondary suture of anastomosis, and covering the lost part of the anastomosis with a patch. This treatment was used in 66 cases (84.5%), and 18 patients (22.8%) needed early secondary operation. 18 patients (22.8%) had a vascular prosthesis infection.

Results. A good treatment result of anastomotic aneurysms was observed in 64 patients (81%).

In 10 cases (12.7%), amputation was needed due to lack of blood recirculation in the limbs.

Five patients died because of MODS due to vascular prosthesis infection.

Conclusions. 1. The most important complication resulting in surgical treatment failure is vascular prosthesis infection and the progress of peripheral arteriosclerosis. 2. Distant vascular anastomosis dehiscence may show that the anastomosis was done using too much tension or that there were dakron physicochemical changes due to the aging process.

Kostewicz W: Badania nad tętniakami rzekomymi w zespoleniu dalszym protezy aortalno/biodrowo-udowej. Pol Przegl Chir 1998; 10.

Melliere D, Berrahal D, Becquemin JP, el: False anastomotic aneurysmsafter aorto-femoral prosthesis. Detection, prevention and treatment. J Mal Vasc 1996; 21(3): 158-64.

Levi N, Schroeder TV: Anastomotic femoral aneurysms: is an increase in interval between primary operation and aneurysms formation related to change in incidence. Panminerva Med 1998; 40(3): 210-13.

Waibel P: False aneurysm after reconstruction for peripherial arterial occlusive disease. Observation over 15 to 25 years. Vasa 1994; 23(1): 43-51.

Skourtis G, Bountouris I, Papacharalambous G, et al.: Anastomotic pseudoaneurysms: Our experience with 49 cases. AnnVasc Surg 2006; 24.

Melliere D, Becquemin JP, Cervantes-Monteil F, et al.: Recurrent femoral anastomotic false aneurysms: is long term repair possible? Cardiovasc Surg 1996: 4(4): 480-82.

Aguiar ET, Langer B, Lobato AC Risk of development of false aneurysm and graft intection after aorta-femoral bypass graft. Retrospective study. Report of 211 cases. J Mal Vasc 1996; 21(1): 36-39.

Pogorzelski R, Macioch W, Ostrowski T i wsp: Tętniaki zespoleniowe po operacjach naprawczych tętnic kończyn dolnych. Pol Przegl Chir 1996; 68(1): 50-53.

Sciannameo F, Ronca P, Caselli M i wsp: The anastomotic aneurysms. J Cardiovasc Surg 1993; 34(2): 145-51.

Ylonen K, Biancari F, Leo E, et al.: Predictors of development of anastomotic femoral pseudoaneurysms after aortobifemoral reconstruction for abdominal aortic aneurysm. Am J Surg 2004; 187(1): 83-87.

Miyata T, Sato O, Deguchi J i wsp: Anastomotic aneurysms after surgical treatment of Takayasu's arteritis: a 40-year experience. J Vasc Surg 1998; 27(3): 438-45.

Mii S, Mori A, Sakata H i wsp: Para-anastomotic aneurysms: incidence, risk factors, treatment and prognosis. J Cardiovasc Surg 1998; 39(3): 259-66.

Demarche M, Waltregny D, van Damme H, et al.: Femoral anastomotic aneurysms: pathogenic factors, clinical presentations and treatment. A study of 142 cases. Cardiovasc Surg 1999; 7(3): 315-22.

Madiba TE, Nair R, Mars M, et al.: Anastomotic aneurysm following aortobifemoral by-pass. S Afr J Surg 2001; 39(3): 85-87.

Witkowski M, Stryga W, Noszczyk BH: Tętniaki rzekome po zespoleniach protezy z tętnicą udową. Pol Tyg Lek 1996; 51(10-13): 145-47.

Sigala F, Georgopoulos S, Sigalas K i wsp: Femoral anastomotic aneurysms in the modern era: a reappraisal of a continuing chellenge. Minerva Chir 2006; 61(2): 95-101.

Sharma NK, Chin KF, Modgill VK: Pseudoaneurysms of the femoral artery: recommendation for a method of repair. J R Coll Surg Edinb 2001; 46(4): 195-97.

Polish Journal of Surgery

The Journal of Foundation of the Polish Journal of Surgery

Journal Information

CiteScore 2016: 0.29

SCImago Journal Rank (SJR) 2016: 0.166
Source Normalized Impact per Paper (SNIP) 2016: 0.207


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