POSTTRAUMATIC AV FISTULAS AND PSEUDOANEURYSMS

Methods. The authors present the surgical treatment of 20 post-traumat ic arteriovenous fistulas and 33 arterial pseudoaneurysms that have be en treated in the last 5 years in the Centre for Vascular Surgery of t he Institute for Cardiovascular Diseases, Clinical Centre of Serbia in Belgrade. Five women and 45 men (mean age 31.7 years) were examined T here were 28 war and 22 noncombatant injuries. In most cases superfici al femoral artery and vein were involved. The average time elapsed fro m the moment of injury until the operation started, was 9 months in pa tients with AV fistulas, and one month for patients with pseudoaneurys ms. Results. In all of the patients with AV fistulas, arterial and ven ous reconstructions were performed, except in 4 cases where the veins were ligated. Surgical reconstruction was performed in 26 patients wit h pseudoaneurysms, while in 7 cases the artery was Ligated There were no cases of postoperative ischemia in patients due to arterial ligatio n. Patients were followed for 2 years and 2 months postoperatively. As far as the reconstructive operations are concerned, the postoperative patency rate was 100%, while Limb salvage was achieved in 96.9% Namel y, one amputation was done in. spite of high arterial patency rate, wh ich was indicated by massive bone-muscle tissue loss, occurring during mine explosive injury. Conclusions. Because of the rapid disease prog ress, the authors suggest that the operative treatment of post-traumat ic AV fistulas and pseudoaneurysms should be performed as soon as poss ible, This was supported by good follow-up results in operatively trea ted patients.