Anastomotic aneurysms following aortofemoral vascular replacement

Despite the advances in reconstructive vascular surgery, anastomotic aneurysms,--particularly in inguinal position--have remained an unsolved problem. Between 1985 and 1992 in 46 patients who underwent aortoiliac or aortofemoral bypass grafting 58 anastomotic aneurysms were operated in our institution. The mean interval between primary reconstruction and onset was 65.0 months. In 54% we observed real suture aneurysms. Technical faults are supposed to be the most causative factor in development of anastomotic aneurysm. The rate of recurrence after repair was 10%. There was no postoperative mortality. It is concluded that comprehensive follow-up is required after aortofemoral grafting. Because of the risk of peripheral embolization and local disruption surgical repair has to be done soon after the diagnosis of anastomotic aneurysm.