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A 15-year experience with anastomotic aneurysms resulting from peripheral vascular reconstruction is presented. The analysis is divided into three 5-year periods. It is obvious from this presentation that the etiology is probably caused by suture material, end-to-side anastomosis, proximity of the anastomosis to a joint and intimectomy of the recipient artery at the original operative procedure. None of the lesions reported herein were associated with graft or wound sepsis. Anastomotic aneurysms at the proximal aortic suture line resulted in aortoenteric fistulae in 6 of 8 cases. There were no survivors in these 6 cases despite successful graft replacement. It is to be emphasized that the complication of anastomotic aneurysm still remains a significant complication in peripheral vascular surgery with a 1.9% incidence noted in 320 operations performed from 1970-1974.

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