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Anastomotic aneurysm following aortobifemoral bypass
1Vascular Service, University of Natal, Durban.
Insights
Anastomotic aneurysms after aortobifemoral bypass are rare but require management. Surgical repair or excision offers good outcomes with no reported deaths or recurrences in this study.
Area of Science:
- Vascular Surgery
- Surgical Complications
- Aortoiliac Disease
Background:
- Anastomotic aneurysms are a potential complication following bypass surgery.
- Understanding their incidence and management is crucial for patient care.
Purpose of the Study:
- To determine the incidence of anastomotic aneurysms after aortobifemoral bypass.
- To document the management strategies employed for this condition.
Main Methods:
- Prospective study over 49 months at two tertiary referral hospitals.
- 25 anastomotic aneurysms identified in 23 of 492 patients via Doppler ultrasound.
- All identified aneurysms underwent surgical repair.
Main Results:
- No deaths or recurrences were observed post-intervention.
- Common surgical procedures included excision with interposition graft and re-suture.
- Minor complications included wound infections (2 patients) and contralateral limb occlusion (1 patient).
Conclusions:
- Anastomotic aneurysms following aortobifemoral bypass are uncommon.
- Anastomotic disruption is a frequent cause.
- Surgical repair or excision yields favorable results.
Objective:
The aim of this study was to establish the incidence of anastomotic aneurysm following aortobifemoral bypass and to document management of this condition in our practice.
Design:
This is a prospective study of anastomotic aneurysms developing in patients with aortobifemoral bypasses followed up for 49 months.
Setting:
Two tertiary referral hospitals served by the Durban Metropolitan Vascular Service.
Patients:
Four hundred and ninety-two patients underwent aortobifemoral bypass. Anastomotic aneurysms (N = 25) developed in 23 patients. Presence of anastomotic aneurysm was confirmed by Doppler ultrasound.
Interventions:
All patients underwent aneurysm repair.
Results:
Operations performed were: excision and interposition graft (15), re-suture (6), tube graft (1), crossover (1), graft-popliteal bypass (1) and ligation (1). There were no deaths and no recurrences. Wound infections occurred in 2 patients and occlusion of the opposite limb occurred in 1.
Conclusion:
Anastomotic aneurysms following aortobifemoral bypass are uncommon. They commonly occur as a result of anastomotic disruption. Management includes repair or excision, depending on the prevailing circumstances, and can be performed with good results.