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Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users

INTRODUCTION: Management of pseudoaneurysms in intravenous drug users is complex and challenging due to an associated infection and unavailability of autologous vein grafts. Here we observe the outcomes of ligation and local debridement as a primary modality of treatment in this subset of patients w...

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Autores principales: Jaiswal, Lokesh Shekher, Pandit, Narendra, Adhikary, Shailesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Journal of the Nepal Medical Association 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827506/
https://www.ncbi.nlm.nih.gov/pubmed/31477961
http://dx.doi.org/10.31729/jnma.4472
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author Jaiswal, Lokesh Shekher
Pandit, Narendra
Adhikary, Shailesh
author_facet Jaiswal, Lokesh Shekher
Pandit, Narendra
Adhikary, Shailesh
author_sort Jaiswal, Lokesh Shekher
collection PubMed
description INTRODUCTION: Management of pseudoaneurysms in intravenous drug users is complex and challenging due to an associated infection and unavailability of autologous vein grafts. Here we observe the outcomes of ligation and local debridement as a primary modality of treatment in this subset of patients with pseudoaneurysms. METHODS: This is a descriptive cross sectional study of 15 patients over a period of 4 years who presented with pseudoaneurysm of peripheral artery from intravenous drug use. In this study, we describe the presentations and management outcomes in 15 patients with peripheral arterial pseudoaneurysmfrom IV drug use. RESULTS: The most common site involved was common femoral artery among 12 (80%) patients followed by superficial femoral artery among 8 (13.3%) patients and external iliac artery in 1 (6.7%) patient. Twelve (80%) patients were having signs of infection. All patients underwent surgical intervention which comprised of excision of pseudoaneurysm and ligation of artery without revascularization among 12 (80%) patients and with revascularization with autologous venous graft among 3 (20%) patients. There was no mortality or a major bleeding requiring re-exploration. None of the patients developed limb ischemia necessitating amputation. One patient with femoral artery ligation without revascularization at one year of follow up is having claudication on brisk walking. There was one saphenous vein graft thrombosis in immediate postoperative period. CONCLUSIONS: With the use of ligation without revascularization technique, there was no mortality or major bleeding requiring re-exploration. None of the patients developed limb ischemia necessitating amputation so this treatment modality seems promising in treatment of pseudoaneurysms in intravenous drug users.
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spelling pubmed-88275062022-02-28 Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users Jaiswal, Lokesh Shekher Pandit, Narendra Adhikary, Shailesh JNMA J Nepal Med Assoc Original Article INTRODUCTION: Management of pseudoaneurysms in intravenous drug users is complex and challenging due to an associated infection and unavailability of autologous vein grafts. Here we observe the outcomes of ligation and local debridement as a primary modality of treatment in this subset of patients with pseudoaneurysms. METHODS: This is a descriptive cross sectional study of 15 patients over a period of 4 years who presented with pseudoaneurysm of peripheral artery from intravenous drug use. In this study, we describe the presentations and management outcomes in 15 patients with peripheral arterial pseudoaneurysmfrom IV drug use. RESULTS: The most common site involved was common femoral artery among 12 (80%) patients followed by superficial femoral artery among 8 (13.3%) patients and external iliac artery in 1 (6.7%) patient. Twelve (80%) patients were having signs of infection. All patients underwent surgical intervention which comprised of excision of pseudoaneurysm and ligation of artery without revascularization among 12 (80%) patients and with revascularization with autologous venous graft among 3 (20%) patients. There was no mortality or a major bleeding requiring re-exploration. None of the patients developed limb ischemia necessitating amputation. One patient with femoral artery ligation without revascularization at one year of follow up is having claudication on brisk walking. There was one saphenous vein graft thrombosis in immediate postoperative period. CONCLUSIONS: With the use of ligation without revascularization technique, there was no mortality or major bleeding requiring re-exploration. None of the patients developed limb ischemia necessitating amputation so this treatment modality seems promising in treatment of pseudoaneurysms in intravenous drug users. Journal of the Nepal Medical Association 2019-06 2019-06-30 /pmc/articles/PMC8827506/ /pubmed/31477961 http://dx.doi.org/10.31729/jnma.4472 Text en © The Author(s) 2018. https://creativecommons.org/licenses/by/4.0/This is an Open-Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jaiswal, Lokesh Shekher
Pandit, Narendra
Adhikary, Shailesh
Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users
title Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users
title_full Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users
title_fullStr Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users
title_full_unstemmed Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users
title_short Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users
title_sort outcome of ligation without revascularization in pseudoaneurysms of peripheral arteries in intravenous drug users
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827506/
https://www.ncbi.nlm.nih.gov/pubmed/31477961
http://dx.doi.org/10.31729/jnma.4472
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