Treatment of Femoral Pseudoaneurysm in Intravenous Drug Abusers

Objective:To explore the characteristics,surgical options and clinical outcomes of femoral pseudoaneurysm in intravenous drug abusers.Methods: Data on thirty drug abusers with ruptured femoral pseudoaneurysm admitted to our hospitals between January 2000 and June 2008 were reviewed and analyzed retrospectively.Twenty-six patients received excision of the pseudoneurysms with revascularization after debridement,including direct vascular anastomosis in 3 patients,artificial blood vessel patch repair in 8,ePTFE vascular grafting in 14 and ligation of the femoral artery in 5.Results: Rejection to surgical treatment resulted in death in 4 patients.25 cases limbs survived with recovered pulsation of the dorsalis pedis artery.Due to post-surgical hemorrhage,three patients suffered redo operations with transfemoral amputation in one.The duration of follow-up ranged from 3 months to 4 years.Intermittent claudication was noted in one of patients who received ligation of the femoral artery.Conclusion: Effective treatment for femoral pseudoaneurysm in intravenous drug abusers should include control of infection,local debridement,pseudoaneurysm resection,blood vessel implantation and repair.Ligation of femoral artery can be performed in case of intractable condition.