Anastomotic aneurysm following aortobifemoral bypass.

Objective: The aim of this study was to establish the incidence of anastomotic 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 bypass. Anastomotic aneurysms (N = 25) developed in 23 patients. Presence of anastomotic 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) and ligation (1). There were no deaths and no recurrences. Wound infections occurred in 2 patients and occlusion of the opposite limb occurred in 1.

Conclusion: Anastomotic aneurysms following aortobifemoral bypass are uncommon. 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.