Outcomes of Femoral Artery Pseudoaneurysm in Intravenous Drug Abusers Managed at a Tertiary Care Center

Abstract

The aim of this study was to assess the effects of ligation and excision of femoral artery pseudoaneurysm without revascularization in intravenous drug abusers presenting in the tertiary care center. MethodsThis was a retrospective study conducted at Shaheed Mohtarma Benazir Bhutto Institute, Karachi, Pakistan, and included 119 patients admitted for vascular injuries of the groin between June 2016 and June 2020. Data collected from the hospital's medical records included all intravenous drug addicts presented with mass near or at groin area only, while other pseudoaneurysm locations secondary to vascular trauma, arteriovenous fistula, and hemodialysis were excluded. SPSS Version 20.0 (IBM Corp., Armonk, NY, USA) was used for data analysis. ResultsThis study included 119 patients, all of whom presented and admitted to the Accident and Emergency Department, with a mean age of about 32 years ± 11.34 years and a mean duration of addiction of 2.47 years ± 1.37 years. Males constituted 83.2% of the patients, while females constituted 16.8%. The left femoral artery was affected more commonly than the right femoral artery, with an average of 75.6% and 24.4%, respectively. The most common presentation was bleeding from ruptured pseudoaneurysm (76.5%) and oozing with pulsatile mass (17.6%), while infected pulsatile swelling and misdiagnosis were uncommon. After surgical intervention, limb salvage was 95.8%, whereas mortality and amputation rate were 2.5 % and 1.7%, respectively. ConclusionThe optimal management of femoral artery pseudoaneurysm in intravenous drug addicts is ligation and excision of the pseudoaneurysm without revascularization.

Managing Splenic Artery Pseudoaneurysms—An Experience from a Developing Country. A Retrospective Review

“…Using International Classification of Diseases (ICD) (10) codes, a total of 10 records of patients with splenic artery aneurysms were retrieved. Out of these patients, nine patients with splenic artery pseudoaneurysm were identified and found eligible for this study.…”

“…In Pakistan, multiple case reports on pseudoaneurysms commonly involving femoral arteries, aorta, and left ventricle have been published. [10][11][12][13] However, data related to splenic pseudoaneurysms are lacking.…”

Femoral artery Pseudo-aneurysm: Presentation, Causation and Outcome in Cardiothoracic Vascular and Transplant Centre of a Tertiary Level Hospital in Nepal

“…Complications included bleeding and reexploraation, debridement, infection and claudication which are similar in incidence with data from other tertiary centres. 1,3,5,10 Even with a large burden of such patients presenting late with multiple complications in our center, the only tertiary level vascular center in Nepal, the outcomes are more promising.…”

“…Our study showed a limb amputation among 18 of the patients which is a high number as compared to contemporary studies. 2,10 Late presentation and infection are the major factors that hinder early revascularization in those with ligation leading to limb ischemia and amputation. Complications included bleeding and reexploraation, debridement, infection and claudication which are similar in incidence with data from other tertiary centres.…”

Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol

“…Moreover, arterial reconstruction may not be required due to adequate residual perfusion of the limb postligation, and thus may pose more risk to the patient 15 16. Rates of major lower limb amputation following ligation vary in the literature from 0% to 3.3% to 33% 16 24–30. The purpose of this systematic review is to analyse published specific outcome following the different surgical management options for the infected arterial pseudoaneurysm secondary to groin injecting drug use.…”