Author/Editor		Flis, Vojko; Miksić, Kazimir
Title		Mikotične psevdoanevrizme skupne stegenske arterije zaradi intravenskega vbrizgavanja mamil
Translated title		Mycotic femoral pseudoaneurysms from intravenous drug abuse
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 4
Publication year		2004
Volume		str. 243-7
Language		slo
Abstract		Background. Parenteral drug abuse is the most common cause of infected femoral artery pseudoaneurysms (IFAP). This complication of intravenous drug abuse is not only limb threatening but can also be life threatening. The management of the IFAP is difficult and controversial Generally speaking, ligation and excision of the pseudoaneurysm without revascularization is accepted procedure in majority of the patients. However it is not regarded as an appropriate procedure for cases where the high probability of amputation is expected from acute interruption of thefemoral artery flow. Patients, methods and results. We present three cases of young (average 20 years, range 28-24) patients with IFAP in which a primary reconstruction was performed due to absence of doppler signal over pedal arteries after ligation of common femoral artery. In two of them complications in form of haemorrhage and repeated infection developed in late postoperative period. The first one, had an excision and ligation while the second one had a reconstruction made by means of a silver impregnated dacron prosthesis. None of the patients required an amputation. Conclusions. Overall prognosis and prognosis of the reconstruction in parenteral drug abuse patients is uncertain because there is a high incidence of postoperative drug injection despite aggressive drug rehabilitation.
Summary		Izhodišča. Parenteralno vbrizgavanje mamil je najpogostejši vzrok za nastanek mikotične psevdoanevrizme skupne stegenske arterije. Ta zaplet intravenskega uživanja mamil ogroža ud in življenje. Ekscizija odmrlega tkiva s podvezavo prizadetih arterij brez arterijske rekonstrukcije je sprejemljiv postopek pri večini takih bolnikov in nosi s seboj še sprejemljivo pooperacijsko obolevnost ter nizko stopnjo amputacije uda. Vendar pa tak postopek ni primeren pri bolnikih, pri katerih zaradi akutne prekinitve pretoka v stegenski arteriji obstaja velika verjetnost amputacije. Bolniki, pastopki in rezultati. Prikazujemo primer treh mladih bolnikov (povprečje 20 let, razpon 18-24), pri katerih je bila zaradi dopplerske odsotnosti pretoka po podvezavi stegenske arterije opravljena primarna rekonstrukcija. Pri dveh so se v poznem pooperacijskem poteku pojavili zapleti v obliki krvavitve in ponovljene okužbe. Pri prvem je bila napravljena ekscizija odmrlega tkiva s podvezavo prizadetih arterij brez arterijske rekonstrukcije, pri drugem pa rekonstrukcija s srebrom prepojeno dakronsko protezo. Nihče od bolnikov ni izgubil uda. Zaključki. Splošna prognoza in prognoza rekonstrukcije sta pri zasvojencih, ki uporabljajo parenteralni vnos mamil, negotovi, saj si navkljub odločnemu zdravljenju zasvojenosti mamila še vedno vbrizgavajo intravensko.
Descriptors		SUBSTANCE ABUSE, INTRAVENOUS ANEURYSM, FALSE ANEURYSM, INFECTED FEMORAL ARTERY ADULT