Nahtaneurysmen als Sp�tkomplikation gef��rekonstruktiver Eingriffe an der unteren Extremit�t

Abstract

29 operations were performed because of an anastomotic aneurysm in 25 patients. The incidence of false aneurysm was 0.7% (4079 reconstructive operations from 1964 to 1979). Arterial reconstructions previous to the formation of aneurysm were: aorto-femoral bifurcation graft 9, ileo-femoral bypass 9, femoro-popliteal reconstructions 11 (4 of them were Sparks' prostheses). 31% of the cases had complications (rupture, thrombosis) when operated, 73% were located in the groin. At the primary operation mostly Dacron had been used. In all instances non-absorbable synthetic suture material has been applied. If the interval between the first operation and the formation of the aneurysms is short infection is to be suspected. The diagnosis of aneurysms distal to the inguinal ligament is easy, aneurysms of the iliac region were found after complications (rupture, thrombosis) had occurred. The most frequent reconstructive procedure was graft interposition, but aneurysmorrhaphy was successful in certain cases. Two patients died postoperatively. Follow-up showed one recurrence (in the groin). We suggest that 1) insufficiency of the suture line because of tension 2) dilation of prosthetic dacron material have great importance for formation of anastomotic aneurysm, whereas local endarterectomy or end-side anastomosis do not seem to be significant.

Nahtaneurysmen - Ätiopathogenese, Symptomatologie, Diagnostik, Therapie, Outcome und Einflussfaktoren nach offen gefäßchirurgischer und interventioneller Rekonstruktion

“…Die Mehrheit der NA in der Leistenregion mit einer Inzidenz von 38,5 % bis 88 % werden von etlichen Studien bestätigt [17,32,33,34,35]. Im Patientenkollektiv von Harnoss et al sind 88 % der NA in der Leistenregion, 4,5 % jeweils in der Aorta bzw.…”