Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Introduction: Infected femoral artery pseudo aneurysm (IFAP) is a severe complication in parenteral drug abusers. Aim of the study: To prove that stump pressure above 60 mm Hg measured intraoperatively after ligation of infected femoral artery pseudo aneurysms is sufficient parameter to depend upon for limb salvage. Patients and methods: In this prospective study, 20 patients presented to the vascular surgery emergency department at Kasr-Alaini hospital with infected femoral artery pseudo aneurysms due to parenteral drug injection. Measurement of stump pressures in the femoral arteries intraoperativly was done in all patients after ligation, and if it's more than 60 mmHg, no revascularization procedure would be done, and patients would be observed for signs of acute ischemia and if it occurs, revascularization would be considered and if the stump pressure is less than 60 mm Hg after ligation, revascularization would be considered from the start. Results: All patients were males. The mean age was 36.9+-7.2 Stump pressure (SP) was <60mmHG in 8 patients who underwent trans-obturator bypass from the start. Stump pressure (SP) was {u2265}60mmHG in 12 patients who underwent ligation without revascularization and only one patient suffered from acute ischemia following ligation to which trans-obturator bypass was do. Follow up:- In the 11 patients who underwent ligation without revascularization, 9 patients had mild claudication (82%), 1 patient had above knee amputation (9%) and 1patient died (9%) from 2nd haemorrhage following ligation. On the other hand, those underwent trans-obturator bypass, 3patients complicated by graft occlusions (33%), two of them had above knee amputation, while the third had hip disarticulation

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