Introduction: Infected pseudoaneurysms among intravenous drug abusers are a serious clinical condition that carries significant morbidity and mortality. The management of such cases has been controversial on deciding the need of revascularisation following simple ligation and local debridement. In this audit, we present the results of simple ligation and local debridement of our patients with infected pseudoaneurysm. Materials and methods: We conducted a retrospective review from 2013 to 2018 on 15 of our patients who are intravenous drug abusers that underwent simple ligation and local debridement for an infected pseudoaneurysm. Results: All 15 patients underwent simple ligation and local debridement. They were all male patients, and majority of the patients were between group ages of 30-40 years old at 66.7%. The oldest patient was 63 years old. All the patients self-injected the affected site for a minimum duration of 36 months. 73% of the patients had femoral pseudoaneurysm, making it the most common affected site in our audit. The remaining patients had axillary and radial pseudoaneurysm and none of our patients had brachial pseudoaneurysms. Majority of our patients were underlying Hepatitis C at 46.7%, 2 of our patients were HIV positive and only one had Hepatitis B. The remaining 5 patients’ statuses were unknown. In accessing the complications, two patients had re-bleeding after the procedure and were eventually discharged well and were uneventful. One patient required amputation as he developed a gangrenous limb within the same admission after ligation and excision of the infected pseudoaneurysm. There were two deaths due to sepsis with multiorgan failure. 10 patients were discharged well without any complications after surgery. Conclusion: Infected pseudoaneurysms can be safely managed with simple ligation and local debridement without revascularisation as they pose acceptable complication rates.
Introduction: Many cancer patients in general require long term venous access such as chemoport for chemotherapy, as well as infusion of fluids and blood taking. However, chemoport insertions carry complications such as infection, blockage, pneumothorax and malposition. We received feedbacks regarding complications endured by patients after chemoport insertion from the respective teams managing the patients in our hospital. In view of that, we conducted a retrospective audit on the chemoport insertions which we have done. Materials and Methods: We conducted a retrospective audit on the chemoport insertions which was planned for open method insertion through cephalic vein performed over the last 4 years from 2014 to 2017. Results: A total of 102 chemoports were inserted. Majority of patient’s ages are 50-59 years old. 88 (86%) of the cases were done via open method whereas another 14 cases were converted to percutaneous route. Majority of patients (55%) of the patients have breast carcinoma followed by colorectal (28%), haematological (12%) and gynaecological malignancies (5%). Complications occurred in 10 patients (rate at 9.8%). Most common complications were catheter related infection (5 cases) followed by wound infection (3 cases) and malposition (2 cases). Malposition was detected on post-operative chest radiograph and revision was done. All catheter related infection occurred in patients with haematological malignancies. Our complication rate of 9.8% is lower than the accepted complication rate of 15-25% worldwide. Conclusion: Chemoport provides a robust vascular access especially for the purpose of chemotherapy infusion. We showed with adequate training and privileging, it can be performed with very limited complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.