Post-traumatic peripheral arterial pseudoaneurysms: Our experience

Abstract

Background: Pseudoaneurysms are usually post-traumatic, iatrogenic, in intravenous drug abusers or due to anastomotic disruption. Pseudoaneurysms continue to be a clinical challenge in recent time.Patients and Methods: In this retrospective study of 10 years, consisting of 60 cases, we aim to document and evaluate the causes, presentation and treatment modalities.Results: All patients underwent surgical intervention. There was no mortality and minimal morbidity. Conclusions: The repair by Saphenous venous interpositional graft is the key to successful management of post-traumatic peripheral arterial pseudoaneurysm. (Ind J Thorac Cardiovasc Surg, 2006; 22: 182-187)

Peripheral Arterial Pseudoaneurysms—a 10-Year Clinical Study

“…In our study, most of the patients were males aged between the second and fourth decade, which is in coherence with the results found by Darbari et al and Mohammadzadeh et al [1,4]. The mean duration of presenting symptoms ranged between 5 and 31 days (median 14 days).…”

“…Concurrent study by Klonaris also showed the range of symptoms from 5 to 50 days [13]. A pulsatile mass with localized tenderness was the commonest presentation in our study, which was observed in a study by Darbari but also patients can present with limb edema, gangrene, or even sepsis [1]. Cold limb at admission 14 28…”

“…Penetrating trauma in the form of stab, industrial injury, firearm discharge, and sometimes manipulation during orthopedic surgery are the other frequent causes [1,4]. The femoral artery is seen to be the commonest artery affected followed by brachial artery as studied by Georgiadis and in our study as well [6].…”

“…The most common postoperative complication in our study was wound infection seen in 15 (30 %) patients, but then, this was the subset of patients with positive wound cultures preoperatively to begin with. Anastomotic blowout is a devastating but rare complication with reported rates being less than 3.3 % [1], and in our study, we did not come across with this complication; however, there was no reported mortality. Extra anatomic bypass through the obturator foramen is another useful technique for placing the graft as it avoids the infected tissues, but it was not employed in our study.…”

“…The characteristic findings are those of a pulsatile mass, palpable thrill, and an audible to-and-fro murmur. Various imaging techniques can be used for diagnosis [1]. Pathologically, the wall of the artery has been breached, and external wall of the aneurysmal sac consists of outer arterial layers, perivascular tissue, blood clot, or a layer of reactive fibrosis [2].…”