Covered Stent Graft Placement For Pseudoaneurysms In Intravenous Drug Users

Objectives: Explore the application of endovascular covered stentplacement in pseudoaneurysms of intravenous drug users.Design:Retrospective study.Materials and methods: We evaluated a consecutiveseries of pseudoaneurysm in intravenous drug users from September2011to November2013.19patients with20arterial pseudoaneurysms admittedduring a26-month period were enrolled in this study. Results: Allparticipating patients were males with a mean age of37.6years.Hemorrhage was the most common reason (94.4%) for seeking medicalcare,3of these patients went into hemorrhagic shock.7patients (35%)underwent ligation without revascularization, while covered stentplacement was performed in13cases (65%). One patient died a monthafter ligation for massive haemorrhage at the surgical site, one lost tofollow up, and3of the rest5who received ligation developed claudication.Despite one case of a new pseudoaneurysm formed due to delayed debridment and one case of stent thrombosis, none of the rest11cases whohad stent graft implanted presented graft infection or claudication.Conclusions: Covered stent graft placement reduces the incidence ofpostoperative claudication. Although infection accompanied was thought tobe a contraindication in traditional view, our studies shows with appropriatebroad-spectrum antibiotics and early debridment, the incidence of stentgraft infection is not high. But the high expense, uncertain long-termprospects and a high demand for compliance make stent graft placementhard to be the first choice. More researches and evidences are required forthe application of stent graft placement in pseudoaneurysms in intravenousdrug users.