Articles

Arterial Ligation for Infected Femoral Psuedo-Aneurysm in Drug Injecting Abusers

Abstract

Pseudo-aneurysm of the femoral artery is the most common arterial complication in drug injecting abusers. Scholars in vascular surgery have published debating statements regarding techniques of successful surgical management during last two decades. We present the results of simple arterial ligation in a series of 32 patients presenting with infected femoral pseudo-aneurysm. Most of the patients were males (89%). Young persons in the age group of 15-44 years were mostly affected. Site of lesion included common femoral artery in 65% , superficial femoral artery 28% and at bifurcation 6.2%. celulitis in 14 (53%), abscess & celulitis in 6 (19%), necrosing fasciitis in 2 (6.2%) and vascular abscess in 7 (22%) cases were the forms of associated local infection. There was no hemorrhage, vascular thrombosis, amputation, or mortality. Claudicating were the only complications identified in 2 patients with Tripe ligation. Ligation is the optimal management for infected pseudo-aneurysms because it is easy, cost-effective, and safe. Early reconstruction is not recommended, since there is an extended infection in the location of the pseudo-aneurysm.

Valentine RJ, Turner WW. Acute vascular insufficiency due to drug injection. In: Rutherford RB, editor. Vascular Surgery. 4th ed. Philadelphia: WB Saunders; 2003. p. 846-53.

Moore WS. Vascular Surgery, A Comprehensive Review. 5th ed. Philadelphia: WB Saunders; 1998.

Reddy DJ, Smith RF, Elliott JP Jr, Haddad GK, Wanek EA. Infected femoral artery false aneurysms in drug addicts: evolution of selective vascular reconstruction. J Vasc Surg 1986;3(5):718-24.

Padberg F Jr, Hobson R 2nd, Lee B, Anderson R, Manno J, Breitbart G, et al. Femoral pseudoaneurysm from drugs of abuse: ligation or reconstruction? J Vasc Surg 1992;15(4):642-8.

Arora S, Weber MA, Fox CJ, Neville R, Lidor A, Sidawy AN. Common femoral artery ligation and local debridement: a safe treatment for infected femoral artery pseudoaneurysms. J Vasc Surg 2001; 33(5): 990-3.

Wright D, Shepard A. Infected femoral artery aneurysm associated with drug abuse. In: Stanley J, Ernst C, editors. Current Therapy in Vascular Surgery. Philadelphia: BC Decker; 1990. p. 350-3.

Patel KR, Semel L, Clauss RH. Routine revascularization with resection of infection femoral pseudoaneurysms from substance abuse. J Vasc Surg 1988;8(3):321-8.

Cheng SW, Fok M, Wong J. Infected femoral pseudoaneurysm in intravenous drug abusers. Br J Surg 1992;79(6):510-2.

Reddy DJ. Treatment of drug-related infected false aneurysm of the femoral artery: is routine revascularization justified? J Vasc Surg 1988;8(3):344-5.

Mohammadzadeh MA, Hossain-Akbar MH, Ejtemaee- Mehr Sh. Vascular lesions in intravascular drug abusers in Guilan, north of Iran. Arch Iranian Med 2007;10(4):522-4.

Rutherford RB, editor. Vascular Surgery. 5th ed. Philadelphia: WB Saunders; 2000.

McIlroy MA, Reddy D, Markowitz N, Saravolatz LD. Infected false aneurysms of the femoral artery in intravenous drug addicts. Rev Infect Dis 1989;11(4):578-85.

Johnson JR, Ledgerwood AM, Lucas CE. Mycotic aneurysm. New concepts in therapy. Arch Surg 1983;118(5): 577-82.

al-Zahrani HA. Vascular complications following intravascular self-injection of addictive drugs. J R Coll Surg Edinb 1997;42(1):50-3.

Kaiser MM, Kujath P, Müller G, Bruch HP. Treatment strategy in inguinal injection abscess and complications. Chirurg 1997;68(10):1029-34.

Levi N, Rordam P, Jensen LP, Schroeder TV. Femoral pseudoaneurysms in drug addicts. Eur J Vasc Endovasc Surg 1997;13(4):361-2.

Salehian MT, Shahid N, Mohseni M, Ghodoosi I,. Marashi SA, Fazel I. Treatment of infected pseudo-aneurysm in drug abusers: ligation or reconstruction? Arch Iranian Med 2006;9(1):49-52.

Naqi SA, Khan HM, Akhtar S, Shah TA. Femoral pseudoaneurysm in drug addicts: excision without revascularization is a viable option. Eur J Vasc Endovasc Surg 2006;31(6):585-7.

Behera A, Menakuru SR, Jindal R. Vascular complications of drug abuse: an Indian experience. ANZ J Surg 2003;73(12):1004-7.

Files
IssueVol 47, No 5 (2009) QRcode
SectionArticles
Keywords
Infected femoral psuedo-aneurysm arterial ligation intravenous drug abusers

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mohammadzade MA, Mohammadzade M, Hossain Akbar M. Arterial Ligation for Infected Femoral Psuedo-Aneurysm in Drug Injecting Abusers. Acta Med Iran. 1;47(5):389-392.