Experience in treating patients with diabetes and anastomotic false aneurysm after reconstructive interventions in the aortic-femoral segment

The purpose of the work isto analyze and improve the results of treatment of patients with diabetes and anastomotic false aneurysm (FA) after reconstructive interventions. Materials and methods. The results of diagnostic examinations in 79 patients with 93 false anastomotic aneurysms were analyzed, the criteria of wound complication (hematoma, infiltrate), patency of shunts, bleeding, heart attack, stroke were evaluated. Among the patients there were 75 (94.9 %) men and 4 (5.1 %) women aged 40—75 years (mean age — (58.4 ± 2.9) years). 69 (87.3 %) patients underwent surgery for atherosclerotic lesions of the pelvic vessels and lower extremities, including 43 (54.4 %) patients with diabetes, 3 (3.8 %) — for abdominal aortic aneurysm, 4 (5.1 %) — after vascular injury, 3 (3.8%) — due to nonspecific aortic arteritis. A total of 79 patients underwent 93 reconstructive interventions. Results and discussion. The time of onset of clinical symptoms (pain, pulsation), which give reason to suspect the occurrence of FA, ranged from 8 days to 19 years: in 15 patients — less than 1 year, in 59 — up to 10 years, in 5 — up to 20 years. The average duration of FA formation after surgery is 62.5 months. The absence of pathological changes in the area of the proximal anastomosis and the presence of adequate outflow pathways in most cases allow us to limit the reconstruction of the distal anastomosis. Conclusions. Early diagnosis and surgical tactics for false anastomotic aneurysms in patients with diabetes can prevent complications and improve the results of surgical treatment. The optimal type of surgery for false aneurysms is their removal with re-prosthesis of the affected segment, which allows to save the limb and the patient's life. The use of modern pharmacological agents allows to reduce the progression of atherosclerosis, which is the main cause of false aneurysms. Dynamic ultrasound monitoring is required for patients who have undergone reconstructive vascular surgery.

Late Complication of Infective Endocarditis: False Aneurism of Ascending Aorta

False aneurysm is one of the life-threatening infective endocarditis (IE) complications. It can occur even long after a well-treated IE. We report the case a 43-year-old. Treated for a blood culture negative aortic valve endocarditis with 4 weeks antibiotic therapy. One year later, he presented a false aneurysm of the right lateral wall of the aorta responsible of right coronary artery compression. He underwent urgent surgery with a successful removal of the false aneurysm and a Bentall’s procedure.

An Unusual Case of an Acquired Aortopulmonary Fistula after Surgical Replacement of a Bicuspid Aortic Valve

Aortopulmonary fistulas are extremely rare and often occur as a result of long-standing aortic aneurysms. They are most frequently due to the erosion of a false aneurysm of the ascending or descending thoracic aorta into the pulmonary artery. Patients generally present with symptoms of acute decompensated heart failure due to a sudden formation of a left-to-right shunt. Here, we present the case of a 63-year-old male who acquired an aortopulmonary fistula four months after undergoing successful bioprosthetic aortic valve replacement.

Reconstruction of brachial artery in posttraumatic false aneurysm

In the article were reflected important issues of ethiopathogenesis, diagnostics and treatment of false aneurysm of brachial artery. Literature view and personnel experience of authors are shown that main causes of developing false aneurysm of brachial artery are non-revealing vessels injuries due to diagnostic-treating mistakes. Despite of using modern methods of mini-invasive treatment of aneurysm treatment till now the open surgery is continued to be a gold standard. In the clinical case are shown all features of diagnostics and successful treatment of false aneurysm of brachial artery with good middle-remote results.

Surgical perspective in pseudoaneurysm of peripheral arteries: a better limb salvage option

Aneurysm involve all three layers of vessel wall. Psudoaneurysm also known as false aneurysm is a collection of blood that forms between the two outer layers of an artery. Femoral and popliteal artery aneurysms account for more than 90% of peripheral aneurysms, with popliteal artery aneurysms being the most common (70%). The estimated incidence of femoral and popliteal aneurysms is approximately 7/100,000 men and 1/100,000 women. Femoral aneurysms usually involve the common femoral artery but may occasionally extend or be limited to the superficial femoral artery (SFA) in the midthigh. Femoral and popliteal aneurysms are commonly associated with other aneurysms, with approximately 80% of patients having multiple aneurysms. Femoral and popliteal aneurysms show a high incidence of thromboembolic complications, which can result in limb loss. Pseudoaneurysm, if left untreated can result in deadly limb loss.