AFSHARFARD A, MOZAFFAR M, FADAEE NAEENI A, AGHAEE MEYBODI F, TOFIGH A. S TUDYING THE RESULTS OF FEMORAL ARTERY LI GATION IN 65 PATIENTS WITH INFECTED P SEUDOANEURYSM DUE TO IV-DRUG ABUSE. Med J Islam Repub Iran 2005; 18 (4) :337-340
URL:
http://mjiri.iums.ac.ir/article-1-617-en.html
From the Department of Vascular Surgery, Shohada Medical Center, Shahid Beheshti University of Medical Sciences, Tehran. Iran.
Abstract: (4641 Views)
Regarding the increasing numbers of IV drug addicts, the incidence of infected
pseudoaneurysm is increasing. So far, different therapeutic strategies have been tried,
but each method has its own drawbacks. Therefore, discovering an appropriate therapeutic
method is necessary.
65 patients with infected pseudoaneurysm due to drug injection referred to Shohada
Medical Center from Feb 1994 till Oct 2003 were chosen. After obtaining proximal
control of the external iliac artery, femoral artery ligation was performed in all patients.
The patients were observed for signs and symptoms of ischemia.
After primary ligation of the involved artery, acute ischemia occurred in only 6
patients who later underwent extra-anatomical bypass. Only 3 patients underwent
amputation. One of them was performed after extra-anatomical bypass and two cases
after arterial ligation, as ischemia and gangrene had been present on admission. During
patient follow up (minimum 3 months, maximum 3 years and average 12 months), 8
cases of slight claudication (9.3 % ) and 3 cases of severe claudication were reported
and the rest have been symptom-free.
Various treatments have been used for infected pseudoaneurysm, but none of
them are faultless. According to infection of the site and existence of extensive necrosis
and inflammatory tissue, anatomical and even non-anatomical bypasses are almost improbable.
The results of this study indicate that arterial ligation could be the fIrst and
probably the best choice of treatment in such patients with less cost and also without
mentionable morbidity or mortality. This procedure must be performed in a vascular
surgery center to perform vascular bypass if needed.