Anastomotic aneurysms of the femoral anastomosis after aortic bifurcation graft

Abstract

A 17 year experience (1958-1975 with anastomotic aneurysms of the femoral anastomosis after aortic bifurcation graft is presented. An anastomotic aneurysm is a progressive dilatation of an anastomosis between an artery and a prosthesis, caused either by a defective suture line or by a wall dilatation. One thousand one hundred and eighty-four femoral anastomoses with a decent follow-up were reviewed and 89 aneurysms were encountered, a per site incidence of 7.5%. Aetiological agents were arterial hypertension, non-infective bad wound healing, type of suture material, defect of the graft and trauma. The therapeutical approach with only 12% recurrences is a segmental interposition. The rate of satisfactory results was 78%. By reducing our bad wound healing from 15 to 10% of the anastomoses over the last five years, we reduced considerably our percentage of anastomotic aneurysms. The use of ultraleight weight prostheses seems to have also reduced the incidence and, in our study that we closed in December 1975, we encountered no aneurysm on Cooley or Milliknit, even with a follow-up of four years. Since the end of the study, however, we encountered one case of bilateral anastomotic aneurysm with Milliknit, one year after the primary operation but with a definite trauma in the anamnesis.