Publication: Management of Pseudoaneurysms in IV Drug Users
Files
Date
2011
Article Type
Original Article
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Volume Title
Pages
Pages: 8 - 11
Publisher
Institute of Medicine
Abstract
Abstract
Introduction: Pseudoaneurysms are major vascular complications in intravenous drug abusers. They are potentially fatal, often infected and require urgent management.
Method: This is a retrospective study of the prevalent practice of their management in our center. The inpatient medical charts of the patients spanning 5 years (Sep 2006 to Aug 2011) were reviewed. Data were obtained on their demographic, clinical, management and outcome parameters.
Result: Among the thirty intravenous drug users presenting with pseudoaneurysms (excluding one who bled to death before surgery), 28 had their femoral artery involved. Most of them (90%) were infected. Nearly half of the patients (45%) were seropositive for HIV and/or HCV. All were operated, with no mortality. Ligation and debridement was the technique used almost exclusively (83%). One brachial artery wasrepaired primarily, whereas 3 femoral and 1 brachial pseudoaneurysms were managed with autologous saphenous vein bypass. Five patients had neurological complications, and 5 others had non-limb threatening claudication which got better with medical management. Mean follow up period was 11 months.
Conclusion: Ligation and debridement appears to be a simple, safe and effective procedure in infected pseudoaneurysms in IV drug users.
Keywords: Claudication, IV Drug Users, Infected Pseudoaneurysms, Ligation
Description
R Sapkota
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Tribhuvan University, Kathmandu, Nepal
S. Sapkota
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Tribhuvan University, Kathmandu, Nepal
B. Thapa
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Tribhuvan University, Kathmandu, Nepal
KR Shrestha
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Tribhuvan University, Kathmandu, Nepal
N Rajbhandari
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Tribhuvan University, Kathmandu, Nepal
UK Shrestha
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Tribhuvan University, Kathmandu, Nepal
Keywords
Claudication, IV Drug Users, Infected Pseudoaneurysms, Ligation
Identifier
https://doi.org/10.59779/jiomnepal.440