Surgical management of infected pseudoaneurysms of femoral artery caused by narcotics injection.

OBJECTIVE: To investigate the surgical management of infected pseudoaneurysms of femoral artery caused by narcotics injection. METHODS: The clinical data of 63 cases of infected pseudoaneurysms of femoral artery caused by narcotics injection were reviewed retrospectively. RESULTS: The tumors in 52 cases ruptured. Rupture hemorrhoea first occurred in 45 patients before admission and in 7 during hospitalization. Twenty-six patients suffered from recurrent or multiple hemorrhoea while in hospital. Forty-nine patients received external iliac artery-superficial femoral artery extra-anatomic bypass reconstruction with banded vascular grafts and the other 14 received ligation operations of the external iliac artery or the femoral artery. No one died in the perioperative period. One patient with vascular graft reconstruction developed graft infection during hospitalization and 5 developed graft infection during the follow-up. No ischemic necrosis occurred in the affected limbs after the infected vascular grafts were removed. One patient developed necrosis in the affected limb after the femoral artery was ligated and then above-knee amputation was performed. The others recovered well. Unobstructed blood circulation in the vascular graft was exhibited by color Doppler ultrasonography in 36 cases during the follow-up. CONCLUSION: Operation as early as possible is the only way to rescue patients' lives threatened by infected pseudoaneurysms of femoral artery caused by narcotics injection. Thorough debridement and drainage, revascularization between external iliac artery and superficial femoral artery using band artificial blood vessel, and controlling infection are therapeutic modus operandi. Ligation of external iliac artery or femoral artery is also a feasible measure to rescue patients' lives when pseudoaneurysms are infected severely.