Recurrent femoral anastomotic false aneurysms: is long term repair possible?

This study was undertaken to evaluate the operative problems and the fate of patients operated on for recurrent femoral anastomotic false aneurysms, following aortofemoral bypass. It was found that 58 of 66 anastomotic false aneurysms which developed after aortoiliac or aortofemoral reconstruction were located at the femoral level, six at the anastomosis of the graft to the aorta and two at the iliac artery anastomosis. Six recurrences developed after surgical repair of femoral anastomotic false aneurysms but there were none after repair of aortic or iliac anastomotic false aneurysms. Of the six recurrences one patient was treated by direct repair and the remaining five by interposition of a prosthetic graft. There were no ischaemic complications or recurrences in a mean of three years. Elective, repeated repair is therefore a successful method of treating anastomotic false aneurysms. Deep sutures should be inserted into the arterial wall, tension should be avoided by placing an interposition graft when necessary, using a careful aseptic technique. Patients should be told to avoid extreme extension and rapid flexion-extension of the hip joint for the rest of their life.