Surgical treatment of post-traumatic pseudoaneurysms and arteriovenous fistulas

OBJECTIVE: To report the experience in the diagn osis and treatment of post-traumatic pseudoaneurysms and arteriovenous fistulas. METHODS: A series of 30 patients (11 women and 19 men) with pos ttraumatic pseudoaneurysms were reviewed retrospectively. Among them 7 patients (5 women and 2 men) were associated with arteriovenous fistula. RESULTS: The causes included sharp penetrating trauma (18 cases ), blunt trauma (6 cases) and iatrogenic arterial injury (6 cases). The main cli nical manifestations consisted of local pulsatile mass (26 cases), vascular brui ts (19 cases), thrill (13 cases), ischemia of distal limb (9 cases), neuropathy (5 cases) and pseudoaneurysm rupture (2 cases). All patients underwent surgery. The operations included: ligation of the vessels (12 cases), surgical resection and primary suture repair of the vascular defect or anastomosis (11 cases), vasc ular reconstruction with autogenous saphenous vein (3 cases) and synthetic vascu lar graft (4 cases). CONCLUSIONS: Because of the imminent clinical course, early op eration is usually indicated. The operative treatment is effective and safe for most of the patients with post-traumatic pseudoaneurysms and arteriovenous fist ulas.