Anastomotic aneurysms--an unsolvable problem.
Despite the advances in reconstructive vascular surgery anastomotic pseudoaneurysms have remained a serious problem. Even if a faultless operative technique is used this complication cannot always be averted. In order to avoid rupture or thromboembolism and to improve the patient's prognosis we suggest that all pseudoaneurysms are treated surgically except in poor risk patients. Between 1981 and 1986 119 anastomotic aneurysms in 68 patients were operated on in our department. 31.0% presented as infected aneurysms. 13.1% were recurrent after preceding aneurysm repair. The most common site was the femoral region following aortobifemoral bypass. Host vessel degeneration and acute inflammation of the anastomotic site seem to be the most important causative factors. Surgical repair usually consisted of resecting the anastomosis together with part of the host artery; in septic aneurysms limb salvage was attempted using extra-anatomic bypass. Postoperative mortality was 8.8%, minor complications occurred in 10.9%; 9 patients (13.1%) had to have an amputation.
Wandschneider
W
W
First Surgical Department, Krankenhaus der Stadt Wien-Lainz, Vienna, Austria.
Bull
P
P
Denck
H
H
D000368:Aged; D000783:Aneurysm / Q000209:etiology / Q000601:surgery; D000785:Aneurysm, Infected / Q000209:etiology / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D013529:Surgical Wound Dehiscence / Q000209:etiology