[Surgical treatment of patients with upper- and lower-limb arterial aneurysms].

From 1968 to 2005, a total of 161 patients presenting with upper- and lower-limb arterial aneurysms were treated at the Federal Facility Russian Scientific Centre of Surgery named after Academician B. V. Petrovskii under the Russian Academy of Medical Sciences. Amongst the most frequently encountered causes of their development appeared to be an injury [86 (53.4%) patients] and atherosclerosis [33 (20.5%) patients]. Radiopaque angiography was performed in 147 (91.3%) of the 161 patients. The presence of a thrombus in an aneurysm was revealed in 97 (66.0%) of the 147 patients. Ultrasonographic duplex scanning carried out in fifty-eight patients demonstrated the presence of a thrombus inside the aneurysmal cavity in forty-three (74.1%) of them. Hundred and thirty-nine (86.3%) patients diagnosed as having arterial aneurysms were subjected to reconstructive operations. More frequently, we performed aneurysmal resections with prosthetic repair of the affected artery or lateral suture of the artery, as well as bypass grafting. Relapses of aneurysms in the remote period were encountered significantly more often in patients who had endured reconstructive operations for infectious, posttraumatic and postoperative aneurysms by means of synthetic plastic materials. Hence, carrying out reconstructive arteries aneurysms irrespective of their sizes is the only reliable method of preventing the development of life-threatening and disabling complications. Operations of choice in the patients diagnosed as having mycotic, postoperative, and posttraumatic arterial aneurysms include aneurysmal resection with an "end-to-end" or an "end-to-side" arterio-arterial anastomosis, or bypass grafting.