Morbidity and Mortality of Reconstructive Surgery of Noninfected False Aneurysms Detected Long After Aortic Prosthetic Reconstruction

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Abstract
FALSE OR anastomotic aneurysms may occur as a late complication after aortoiliac and aortofemoral reconstruction with a prosthesis. The reported prevalence varies between 2% and 29%, depending on how prevalence is calculated, method of screening used, duration of the follow-up period, and number of patients lost to follow-up.1-5 The cumulative incidence of false aneurysm increases with time after the primary reconstruction. In a previous study of long-term results after aortic reconstruction,1 we have demonstrated that the actuarial cumulative incidence of false aneurysms was 23% at 15 years after surgery, a finding that was confirmed by others4 who reported an incidence of 27% after 15 years. False aneurysms may cause morbidity and mortality, although their frequency is not precisely known. It is important to balance the potential benefits of repair against the risks of surgery, especially for small false aneurysms. These patients are more than 10 years older than they were at the time of primary reconstruction. This implies that the cardiopulmonary risk of the repair procedure is probably increased as compared with the risk of the primary reconstruction. Data on the operative risk and outcome of surgical reconstruction of false aneurysms after aortic reconstruction are limited.5-10 To evaluate the risk and results of surgical repair of false aneurysms at the aortic, iliac, and femoral anastomotic sites, we have analyzed the results of a consecutive series of 158 operations in 135 patients with 220 false aneurysms after aortoiliac or aortofemoral prosthetic reconstructions retrieved from our vascular registry.11 Most aneurysms were detected by means of a surveillance program, though some patients who required emergency treatment presented at times different from their schedule of follow-up.