Abstract
We have studied the influence of graft incorporation on the morphology of anastomotic false aneurysm. From 1980 to 1994, 20 patients developed a total of 25 anastomotic false aneurysms; 12 in the aorta and 13 in the femoral artery, These aneurysms occurred an average of 9.1±7.7 (SD) years after the original vascular procedures which included 8 aortoiliac occlusive disease, 7 abdominal aortic aneurysm, and 5 Takayasu arteritis. We have implanted 2 knitted Teflon, 4 woven Teflon, 3 non-velour woven Dacron, 3 non-velour knitted Dacron, and 10 double velour knitted Dacron grafts in the initial operations. Anastomotic false aneurysms developed with woven graft, which showed poor incorporation; all extended along the graft dividing the weak adhesion between the graft and surrounding tissues. In one case, this expansion seemed to influence rapid worsening of the clinical course. Anastomotic false aneurysms also developed with double velour knitted Dacron grafts in spite of their good incorporation. In all but one unidentified case, they were confined to disrupted area of femoral anastomoses. Tight adhesion of the graft to surrounding tissues could prevent aneurysmal progression in these cases. In conclusion, a graft of good incorporation seems to prevent rapid extension of an anastomotic false aneurysm and abrupt deterioration of the clinical course.
