Case Report: False aneurysm as a late unusual complication of the aortofemoral bypass graft in a patient with critical leg ischemic symptoms: interesting case

TL;DR

This case report describes a rare late complication of aortofemoral bypass surgery in an elderly patient, highlighting the importance of regular post-operative imaging to detect pseudoaneurysms.

Contribution

The report emphasizes the rarity and severity of non-anastomotic pseudoaneurysms and advocates for periodic screening in vascular surgery patients.

Findings

Pseudoaneurysms can develop as a late complication of aortofemoral bypass grafts.

Regular post-operative imaging is crucial for early detection and management of pseudoaneurysms.

Non-anastomotic pseudoaneurysms are rare but potentially life-threatening if undetected.

Abstract

Aortofemoral bypass surgery is a common procedure for treating aortoiliac occlusive disease, also known as Leriche syndrome, which can cause lower extremity ischemic symptoms. Diagnostic imaging techniques play a crucial role in managing pseudoaneurysms (PSAs), with Duplex ultrasound and Computed Tomography-angiography (CTA) being effective tools for early diagnosis. Pseudoaneurysms (PSAs) present as pulsating masses with various symptoms, and prompt intervention is essential to avoid complications. A case report is presented involving an 82-year-old male who underwent aorto-bifemoral bypass surgery and later developed a pseudoaneurysm (PSA) of the left branch. Surgical treatment involved the removal of the pseudoaneurysm (PSA) and graft replacement. Other cases from the literature are also described, emphasizing the rarity and potential severity of non-anastomotic pseudoaneurysms (PSAs) in reconstructive vascular surgery. Periodic screening of patients who undergo reconstructive vascular surgery is crucial to detect pseudoaneurysms (PSAs) early and prevent complications. Asymptomatic pseudoaneurysms (PSAs) can grow significantly and become life-threatening if not identified in a timely manner. Regular post-operative imaging, such as annual Computed Tomography-angiography (CTA) and/or Duplex ultrasound, is recommended to ensure early diagnosis and appropriate management of complications.

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