[Infra-inguinal suture aneurysm]

Anastomotic aneurysms represent late complications of reconstructive surgery. They are preferably localized in the inguinal area. From 1975 to 1989 forty patients were operated for 50 infrainguinal anastomotic aneurysms (46 inguinal, 4 popliteal). They developed after a mean time interval of 60.6 months. In nine cases bilateral inguinal aneurysms occurred. Three of the inguinal aneurysms were infected. The inguinal aneurysms were usually treated by total excision followed by prosthetic graft interposition with distal anastomosis to the deep femoral artery. If the superficial femoral artery was patent, it was inserted into the interposed graft. The infected aneurysms were treated with aseptic extra-anatomic bypass procedures. Five patients died after the operation. In one case a transmetatarsal amputation had to be performed and in one case a relapsing aneurysm occurred after three years. In general surgical repair of anastomotic aneurysms following vascular reconstructions should be performed before complications occur. In the inguinal area this can be performed with low local and general risk and with good longterm results.