Ligation of Femoral Artery in Mycotic Aneurysm in Intravenous Drug Abusers

Incidence of femoral artery mycotic aneurysm is increasing due to rising rate of drug abusers. There are multiple surgical procedures for mycotic aneurysm with different complications. Surgical treatments include extensive debridement and revascularization with autogen or synthetic grafts, primary or delayed and ligation of femoral artery without any revascularization. The aim of this study was to evaluate the outcome of femoral artery ligation in treatment of mycotic aneurysm without revascularization among IV drug abusers. This is a retrospective, descriptive study in 44 drug abusers who suffered from femoral mycotic aneurysm who were referred to Imam Khomeini and Razi Hospital during 2001-2004. All patients, operated on by just by femoral artery ligation and debridement without revascularization. Limb salvage and disability followed up for two years after operation. In 2 cases (out of a total 44 cases) amputation was performed after femoral artery ligation (95% limb salvage). Intermittent claudication occurred in 5 cases (11.9%) and two (40 %) out of these 5 cases had delayed revascularization by synthetic graft prosthesis. Paresthesia occurred in 2 cases. There are high complications with low success rate for primary revascularization in these patients either anatomical or extraanatomical due to extensive infection and sepsis. According to excellent surgical outcomes among our patients (95% limb salvage), we recommended that femoral artery ligation and debridement without any revascularization procedures be used. This method is safe, fast and effective in limb saving treatment for femoral mycotic aneurysm in IV drug abusers.