Anastomotic aneurysm following aortobifemoral bypass.

OBJECTIVE

The aim of this study was to establish the incidence of anastomotic aneurysm following aortobifemoral bypass and to document management of this condition in our practice.

DESIGN

This is a prospective study of anastomotic aneurysms developing in patients with aortobifemoral bypasses followed up for 49 months.

SETTING

Two tertiary referral hospitals served by the Durban Metropolitan Vascular Service.

PATIENTS

Four hundred and ninety-two patients underwent aortobifemoral bypass. Anastomotic aneurysms (N = 25) developed in 23 patients. Presence of anastomotic aneurysm was confirmed by Doppler ultrasound.

INTERVENTIONS

All patients underwent aneurysm repair.

RESULTS

Operations performed were: excision and interposition graft (15), re-suture (6), tube graft (1), crossover (1), graft-popliteal bypass (1) and ligation (1). There were no deaths and no recurrences. Wound infections occurred in 2 patients and occlusion of the opposite limb occurred in 1.

CONCLUSION

Anastomotic aneurysms following aortobifemoral bypass are uncommon. They commonly occur as a result of anastomotic disruption. Management includes repair or excision, depending on the prevailing circumstances, and can be performed with good results.