Surgical approach to vascular complications of intravenous drug abuse.

OBJECTIVE: To assess the complications related to intravenous drug abuse.

DESIGN: Prospective study.

METHODS: Intravenous drug abusers (IVDAs) with vascular complications were assessed.

RESULTS: Sixty-two patients presented with swelling and tenderness in the groin, and 3 patients with similar lesions in the cubital fossa. Infected pseudoaneurysms and deep vein thrombosis (DVTs) were diagnosed in 41 and 31 patients respectively (27 patients had both lesions). In patients with infected pseudoaneurysms, 9 patients underwent excision with early revascularization and 32 patients underwent ligation without revascularization. For all patients with femoral vein thrombosis ligation and excision was performed. 4 patients with pure DVTs were managed conservatively. Disabling claudication occurred in 6 patients. Four of them underwent late revascularization with an acceptable outcome.

CONCLUSIONS: Ligation without revascularization is the appropriate treatment of infected pseudoaneurysms in IVDAs. Late revascularization is of great importance in patients with disabling claudication after treatment of addiction. Pure septic DVTs can be managed conservatively.