Key result
Open repair of complex femoral anastomotic aneurysms is linked to ~13% mortality.
Why the study?
Anastomotic aneurysms are late complications of aortic-iliac-femoral reconstruction, and outcomes of open and endovascular repair for complex aneurysms require evaluation.
What are the outcomes of open and endovascular repair for complex aortic, iliac, and femoral anastomotic aneurysms?
Observational (n=100)
Yes
What are the outcomes of open and endovascular repair for complex aortic, iliac, and femoral anastomotic aneurysms?
Most aortic and iliac anastomotic aneurysms can be successfully repaired with endovascular or open techniques, whereas complex femoral anastomotic aneurysms require open repair and are associated with longer operative times and greater blood loss but similar mortality to non-complex cases.
Repair of complex anastomotic aneurysms is feasible by open or endovascular approaches in selected patients; leaves open optimal technique and durability.
Anastomotic aneurysms (AA) manifest as late complications of aortic-iliac-femoral reconstruction with a prosthetic graft. We studied open and endovascular repair of complex aortic iliac and femoral AA was performed for (A) Rupture, (B) Large symptomatic aneurysms, (C) Recurrent, (D) Femoral AA requiring simultaneous arterial reconstruction for critical limb ischemia in two teaching hospitals. Between 1990 and 2024, 100 aorto-femoral-iliac AA were repaired with 32 representing complex AA involving aorta (n = 6), iliac (n = 3), femoral (n = 23). Aortic and iliac anastomotic aneurysms underwent endovascular repairs in 5 patients and open repair in 4 patients with satisfactory outcomes in all. All 23 patients presenting with complex femoral anastomotic aneurysms were repaired via open technique, including five presenting with rupture with mortality in two, and one mortality among those presenting with large aneurysms. Complex femoral AA take longer to present after index operative, showed greater operative time, intra-operative blood loss but had similar mortality to patients with non-complex AAs. Most aortic and iliac AA can be repaired with endovascular and open techniques with satisfactory results, while complex femoral AA required open repair.
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Pansuriya et al. (2025) conducted an observational in Complex aortic, iliac, and femoral anastomotic aneurysms (n=100). Open and endovascular repair vs. Non-complex anastomotic aneurysms was evaluated on Mortality. Complex femoral anastomotic aneurysms required open repair, resulting in 3 deaths among 23 patients, while aortic and iliac aneurysms were successfully treated with open or endovascular repair.
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