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Anastomotic Aneurysms in the Groin - Results of Surgical Treatment

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Pogorzelski R., Wołoszko T., Szostek M., Macioch W., Leszczyński J., Jakuczun W., Małek A., Skórski M., Szostek M.
Polish Journal of Surgery
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2007
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vol. 79
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issue 10
635-642
EN
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.
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Anastomotic aneurysms- 20-years of experience from one center

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Pogorzelski R., Fiszer P., Toutounchi S., Krajewska E., Szostek M. M., Tworus R., Jakuczun W., Skórski M.
Polish Journal of Surgery
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2013
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vol. 85
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issue 4
181-191
EN
Anastomotic aneurysms may develop after any type of vascular surgery, in different areas of the arterial system, and require reoperation. The frequency of occurrence of the above-mentioned is estimated at 1-5%. Material and methods. During the period between 1989 and 2010, 180 patients with 230 anastomotic aneurysms were subject to surgical intervention at the Department of General and Thoracic Surgery, Warsaw Medical University. The study group comprised 21 (11.7%) female and 159 (88.3%) male patients, aged between 30 and 87 years (mean age - 62.8 years). In relation to the number of anastomoses aneurysms were diagnosed in 2.1% of cases. Twenty-four (10.4%) patients were diagnosed with recurrent aneurysms. Results. Surgical procedures performed were as follows: artificial prosthesis implantation (119), reanastomosis (40), patch plasty (25), graftectomy (19), prosthesis replacement (9), and stent-graft (7) implantation. 195 (84.8%) aneurysms were subject to planned surgery, while 35 (15.2%) required emergency intervention. 77.8% of patients were diagnosed with aseptic aneurysms, while the remaining 22.2% with infected perioperative aneurysms. Good treatment results were obtained in 149 (82.8%) patients. Limb amputations were performed in 19 (10.5%) cases. Twelve (6.7%) patients died as a consequence of infection and general complications. Conclusions. Vascular reoperations are a difficult clinical problem and are burdened with a high rate of complications. The above-mentioned often require complex treatment, in order to improve therapeutic results.
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