[Repair and reconstruction of infective femoral false aneurysm caused by drug injection].

OBJECTIVE

To summarize the revascularization method of infective femoral false aneurysm caused by drug injection.

METHODS

Between November 2003 and May 2009, 84 patients with infective femoral false aneurysm caused by drug injection were treated, and the clinical data were analysed retrospectively. There were 67 males and 17 females with an average age of 34.6 years (range, 19-51 years). The average duration of drug injection was 2.7 years (range, 1-11 years). In 13 cases, the defect of femoral artery was 3-10 cm; defect ranged from 1.0 cm x 0.3 cm to 3.0 cm x 0.7 cm in the others. The surgical treatment included bypass using synthetic grafts in 5 cases, great saphenous veins transplantation in 29 cases, repair of femoral artery in 24 cases, and ligation of femoral artery in 26 cases.

RESULTS

Two cases died of intraoperative pulmonary embolism. Eight cases had postoperative wound infection, which was cured after changing dressings. Incisions healed by first intention in the other patients. A total of 82 cases were followed up 12-36 months (mean, 17.3 months). In 56 patients undergoing artery reconstruction or repair, dorsal pedis artery pulse was significantly improved, and no distal osteofascial compartment syndrome occurred. In 26 patients undergoing femoral artery ligation, angiography at 1 week after operation showed abundant collateral circulation from ipsilateral internal iliac artery, superior gluteal artery or contralateral internal iliac artery. Three cases had postoperative intermittent claudication which was improved after symptomatic treatment.

CONCLUSION

Infective femoral false aneurysm caused by drug injection should be treated surgically as early as possible, and effective treatments include debridement, drainage, defect repair or bypass with synthetic graft or great saphenous vein from homonymy external iliac artery to superficial femoral artery. Ligation of femoral artery is an option in patients with serious infection when revascularization is impossible.