Ergebnisse nach gefäßchirurgischer Versorgung von Leistennahtaneurysmen

Abstract

Background

Suture aneurysms (SA) have increasingly become a relevant focus of secondary care.

The aim of the study was to detect the occurrence of SA as a late complication in patients of a certified center of vascular medicine in a retrospective case series and based on operative management experiences as well as selective references from the literature. Patients and methods

Over a defined observational time period all consecutive patients with inguinal SA were documented in a computer-based data registry as part of this retrospective single center observational study. The cases were characterized by patient-dependent factors (age, sex ratio), SA size, vascular surgical approach (e.g. aneurysmorrhaphy ± patch vs. interponate) and outcome aspects (patency rate, SA recurrence, morbidity, mortality). Results

The majority of SA occurred after implantation of an aorto-bifemoral prosthesis (52.3%) in the groin. The mean time interval to SA manifestation in the groin was 55.4 months. More than half of SA (n = 44; 51.2%) were treated with an interponate—aneurysmorrhaphy ± patch showed a significantly higher probability for generation of SA compared with an interponate (p = 0.026 and p = 0.006, respectively). The mean diameter of the inguinal SA was 46.4 mm. In the spectrum of postoperative complications, the most frequent problems were lymphocele with no need for surgical intervention (25.6%), hematoma with need of surgical intervention (8.1%) and infections with necessary postoperative explantation of alloplastic materials (4.7%). The 30-day mortality was 2.3%. Emergency operations for SA showed only a tendency to higher probability of postoperative complications (p = 0.09). Conclusion

SA with an incidence of 0.2–15% can be considered a not uncommon and, thus, noteworthy complication in vascular surgery. Open reconstruction remains the standard procedure for SA at the groin (in particular, implantation of an interponate). Postoperatively, all patients need to be notified on the importance of a regular and life-long vascular surgical follow-up.