Anastomotic Aneurysms in the Groin - Results of Surgical Treatment

Abstract

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.