بررسي نتايج ليگاتور شريان راني در مبتلايان به آنوريسم كاذب عفوني ناشي از تروما در بيمارستان الزهرا اصفهان طي سال هاي 86 - 1385

Evaluating the outcomes of femoral artery ligature among the trauma induced infectious psudoaneurysm in Alzahra-Isfahan hospital during 2006-7

Background: Pseudoaneurysm is a relatively common vascular disease which may occur despite the technological advances and excessive use of femoral artery catheterization (therapeutic and diagnostic). The aim of this study was to determine the therapeutic complications and consequences of femoral artery legation compared to other procedures applied for trauma-induced infectious pseudoaneurysms. Materials and Methods: Through a cross-sectional study, all patients with infectious femoral artery pseudoaneurysm referring to hospital during 2006-7 were included. To collect the data, checklists consisted of questions about age, sex, patientsʹ chief complaints, clinical signs, organ paresthesia, edema, purulent discharge, subcutaneous emphysema, pulse, aneurysm site, presence or absence of concurrent venous involvement and/or artriovenous fistula, way of aneurysm repair, the extent of debridement, and clinical manifestations of the limb after surgery. On a 6-month postsurgery follow up all data were recorded in related checklists. Results: Thirty-three pseudoaneurysm patients were studied. The mean age of the cases was 34/31± 11/36 years. Pain was among the patientsʹ chief complaint. Major sign of the disease on physical examination was: palpable mass pulsating in 57.6% and non-pulsating in 15.2% of cases. For 81.8%, 9.1%, and 9.1% of the cases, arterial legation, excision, and arterial bypass were done, respectively. While none of the patients undergoing arterial excision and bypass had gangrene, 12.5% of the cases undergoing artery legation had gangrene and lower limb amputation. Twenty percent were positive for HCV, 28% positive for HBS and 11% positive for both HCV and HBS. In addition, 10% of the patients were positive for HIV. Conclusion: Considering the more convenient and available technique of arterial legation and also taking into account of the fact that only 10% of the patients need vascularation after legation, surgery of femoral artery legation, particularly in patients with infectious pseudoaneurysm is recommended.