This paper describes a sizeable subgroup of the AIDS caseload that has not been widely studied, that is, men with histories of both male homosexual activity and intravenous drug use. In this paper we identify differences and similarities between gay intravenous drug users and gay men with different histories of drug use; examine the relationship between HIV seropositivity and different patterns of drug use; and estimate whether gay intravenous drug users are more likely than other gay men to be a source of continued HIV transmission.
Introduction: Management of pseudoaneurysms in intravenous drug users is complex andchallenging due to an associated infection and unavailability of autologous vein grafts. Here weobserve the outcomes of ligation and local debridement as a primary modality of treatment in thissubset of patients with pseudoaneurysms.
Methods: This is a descriptive cross sectional study of 15patients over a period of 4 years whopresented with pseudoaneurysm of peripheral artery from intravenous drug use. In this study,we describe the presentations and management outcomes in 15 patients with peripheral arterialpseudoaneurysmfrom IV drug use.
Results: The most common site involved was common femoral artery among 12 (80%) patientsfollowed by superficial femoral artery among 8 (13.3%) patients and external iliac artery in 1 (6.7%)patient. Twelve (80%) patients were having signs of infection. All patients underwent surgicalintervention which comprised of excision of pseudoaneurysm and ligation of artery withoutrevascularization among 12 (80%) patients and with revascularization with autologous venous graftamong 3 (20%) patients. There was no mortality or a major bleeding requiring re-exploration. Noneof the patients developed limb ischemia necessitating amputation.One patient with femoral arteryligation without revascularization at one year of follow up is having claudication on brisk walking.There was one saphenous vein graft thrombosis in immediate postoperative period.
Conclusions: With the use of ligation without revascularization technique, there was no mortality ormajor bleeding requiring re-exploration. None of the patients developed limb ischemia necessitatingamputation so this treatment modality seems promising in treatment of pseudoaneurysms inintravenous drug users.
Outcomes of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users