[Surgical treatment of pseudoaneurysms of the proximal anastomosis after aortofemoral reconstructions].

The authors discuss surgical treatment of pseudoaneurysms of proximal anastomoses of prostheses with the aorta after reconstructive operations in the aortofemoral zone in 9 patients, whose ages ranged from 32 to 65 years. The time between the formation of the aneurysms and the operation before their diagnosis ranged from 15 days to 6 years. The pseudoaneurysms developed due to infection in 3 patients, poor-quality suture material (silk) in one patient, endarterectomy from the aorta at the proximal anastomosis in one patient, and further development of the principal disease in 2 patients; the cause of the disease in 2 patients could not be identified. Six patients were subjected earlier to bifurcation aortofemoral shunting, one patient to bifurcation aortofemoral prosthetics, and 2 patients to linear prosthetics of the infrarenal part of the aorta. The primary reconstructive operation was conducted for occlusive lesions of the aortofemoral zone in 7 patients (of atherosclerotic genesis in 6 of them and one patient had unspecific aortoarteritis), and for aneurysm of the abdominal aorta in 2 patients (of posttraumatic origin on one). The authors claim resection with repeated replacement of the aorta by a linear or bifurcation prosthesis to be the optimal method for reconstruction in pseudoaneurysms of proximal anastomoses. One patient died in the immediate postoperative period. The immediate and late-term results of repeated operations were good in 8 of 9 patients in follow-up periods of 8 months to 5 years. Recurrences of the disease were not encountered.