Anastomotic aneurysm following aortobifemoral bypass

Objective. The aim of this study was to establish the incidence of anastomo tic aneurysm following aortobifemoral bypass and to document management of this condition in our practice. Design. This is a prospective study of anastomotic aneurysms developing in patients with aortobifemoral bypasses followed up for 49 months. Setting. Two tertiary referral hospitals served by the Durban Metropolitan Vascular Service. Patients. Four hundred and ninety-two patients underwent aortobifemoral byp ass. Anastomotic aneurysms (N = 25) developed in 23 patients. Presence of a nastomotic aneurysm was confirmed by Doppler ultrasound. Interventions. All patients underwent aneurysm repair. Results. Operations performed were: excision and interposition graft (15), re-suture (6), tube graft (1), crossover (1), graft-popliteal bypass (1) an d ligation (1). There were no deaths and no recurrences. Wound infections o ccurred in 2 patients and occlusion of the opposite limb occurred in 1. Conclusion. Anastomotic aneurysms following aortobifemoral bypass are uncom mon. They commonly occur as a result of anastomotic disruption. Management includes repair or excision, depending on the prevailing circumstances, and can be performed with good results.