Surgical treatment of anastomotic false aneurysm. A 16-year experience

Surgical treatment of anastomotic false aneurysm, encountered during the last 16 years, has been reviewed. Forty anastomoses were complicated by false aneurysm appearance in 30 patients (27 M, 3 F). They represent 2.1% of our general series of anastomoses considered at risk for false aneurysm formation. Smoking and associate pathologies have been evaluated comparing their percentages in the false aneurysm group to the general series. No statistical difference was noticed except for smoking which was more common in patients affected by false aneurysm (p < 0.001). Hypertension was not a cause of false aneurysm development. Local thromboendoarterectomy at the site of femoral artery was a cause of non-infective false aneurysm formation (p < 0.001). Previous skin dehiscence after vascular reconstruction of the femoral site was demonstrated to be cause of later false aneurysm formation (p < 0.001). Surgical treatment has been considered for infected false aneurysms (21/40) and non-infected ones (19/40). Infected false aneurysms should be treated as infected grafts by removing the graft entirely and replacing it with a reconstruction as far distant as possible from the site of infection. Non-infected false aneurysm can be treated with a local resection of the false aneurysm and graft interposition. Reanastomosis should be considered as a second choice treatment when a small false aneurysm is present. Good long- and short-term results were demonstrated in non-infected false aneurysms, whereas the infected ones showed a worse prognosis which was comparable to infected grafts.