False aneurysms after prosthetic reconstructions for aortoiliac obstructive disease

Area of Science:

• Vascular Surgery
• Medical Device Complications
• Aortoiliac Disease

Background:

• Prosthetic reconstruction is a common treatment for aortoiliac obstructive disease.
• False aneurysms are a known complication following arterial prosthetic procedures.
• Long-term outcomes and risk factors for false aneurysm development require further investigation.

Purpose of the Study:

• To evaluate the incidence and risk factors of false aneurysm development after aortoiliac obstructive disease prosthetic reconstruction.
• To determine the long-term outcomes of patients undergoing aortoiliofemoral arterial prostheses.

Main Methods:

• Retrospective evaluation of 518 patients with implanted arterial prostheses in the aortoiliofemoral tract.
• Analysis of long-term follow-up data (up to 20 years) including patient and anastomosis-specific incidences.
• Life-table method used to calculate the probability of developing false aneurysms over time.

Main Results:

• A total of 101 false aneurysms were detected in 69 patients (13.3% incidence per patient).
• Femoral anastomoses had the highest incidence (13.6%), followed by iliac (6.3%) and aortic (4.8%).
• Hypertension, multilevel disease, suture material, and anastomosis type were significantly correlated with false aneurysm development.

Conclusions:

• False aneurysm development is an unexpectedly high risk for long-term survivors of aortoiliac/aortofemoral prosthetic reconstructions.
• Lifelong follow-up with periodic angiography and ultrasonography is recommended for early detection.
• Risk stratification based on patient and surgical factors may improve patient management.