Abstract
A 69-year-old man with diabetes developed a pseudoaneurysm in the right groin 3 years after bilateral femoro-popliteal bypasses with PTFE grafts. There were no local signs of infection and the pseudoaneurysm was repaired by re-suturing. Wound healing was prolonged and debridement was necessary before discharge. Two months after the operation, a pseudoaneurysm recurred. Although no signs of infection at the onset and during recurrence were observed, we resected the pseudoaneurysm and interposed a new graft from the external iliac artery to the distal graft detouring outside the groin, because of suspected occult infection. The pseudoaneurysms developed on the side which we anastomosed after endarterectomy at the original operation. The main cause of the pseudoaneurysms appears to be the degeneration of the host artery, but occult infection cannot be excluded as the patient had tinea pedis, administered insulin self-injection, and had prolonged wound healing. Interposition grafting would appear to be the method of choice for the repair of pseudoaneurysms, rather than simple re-suturing.
