Outcome of Management of Mycotic Pseudoaneurysms of Femoral Artery in IV drug abusers

Objective: The purpose of this study is to 'determine the outcome of femoral vessels ligation and debridement in infected femoral aneurysm in intravenous drug addicts'. Study design: Descriptive case series Setting: All surgical wards of Mayo Hospital Lahore / King Edward Medical University. Duration of study: The study was conducted from February 12, 2009 to August 12, 2009(6 months). Subjects and methods: All male patients who had inguinal swelling and history of intravenous drug addiction were included in the study. Diagnosis of infected femoral artery pseudoaneurysm was made on clinical basis. In all patients both proximal and distal ends of femoral vessels were ligated and debridment of the wound was done. Results: A total of 40 patients were selected during the study period. Ligation of vessels and debridement of the wound were performed in all patients. 9 patients with the percentage of 22.5% had distal amputations and 11 patients with the percentage of 27%, experienced intermittent claudication. The most common co morbid factor was diabetes mellitus with a percentage of 35% (14 patients). Similarly, due to needle sharing, 17 patients(42%) became anti HCV positive, 14 patients(35%) became anti HBSAg positive and 4 patients(10%) had HIV in their blood. Conclusion: We concluded from our study that ligation of both ends of femoral vessels and local debridement of the wound is one of the best treatment option of femoral artery pseudoaneurysm resulting in acceptable outcome.