Femoral pseudoaneurysm in Addicts

OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five patients who had a primary vascular reconstruction. Two out of two patients who had a triple ligation of their aneurysms had claudication postoperatively...

Four cases of femoral pseudoaneurysms from substance abuse are presented. One patient, a 32 year-old women needed amputation (by disarticulation of the hip) after failed revascularization. Another patient had symptoms of claudication after triple ligation and resection without bypass grafting. The last two had an uneventful recovery: one after saphenous vein bypass, the other after simple resection and repair with a vein patch.

There has been an increase in the incidence of major vascular complications of intravenous drug addiction. We studied five patients who had infected venous pseudoaneurysms of the femoral vein. Patients may have cryptic sepsis or an infected hematoma from venous rupture. The vein containing pus may drain through a venipuncture site. Treatment is complete excision of the involved vein with packing of the wound. Complications due to septic embolization or metastatic infection from septicemia are common. Venous reconstruction is unwarranted...

Infected femoral artery pseudoaneurysms in narcotic addicts present challenging management options. Our policy of routine revascularization is based on the concern that a high rate of amputations must follow ligation and resection alone or with selective delayed revascularization. Fifteen of 16 patients with infected pseudoaneurysms of femoral arteries, treated with resection and bypass grafts, were observed from 1 to 44 months. Obturator bypass grafts were used in 10 patients, iliac-femoral grafts in three, axillopopliteal in one, and right external iliac crossover to left popliteal in one patient...

The result of surgical treatment of 21 infected femoral pseudoaneurysms in 19 intravenous drug addicts was evaluated. Eight pseudoaneurysms involved only the common or superficial femoral artery and 13 involved the femoral bifurcation. Excision and ligation was performed as the sole procedure in 19 instances, and revascularization by bypass through the obturator route was carried out in two. The mean follow-up was 12.3 months. One patient required an above-knee amputation. The resultant ischaemia was greater after triple vessel ligation (mean ankle:brachial pressure index (ABPI) 0...