Evaluation of pseudoaneurysm management post multiple injections in drug abuser using endovascular approach by covered stent

Abstract:
Background: Femoral pseudoaneurysm considered the common complication of repeated femoral puncture during drug addiction by self-trials injections. Pseudo aneurysms form at the different sites arterial entrance (femoral, brachial, radial…) if not sealed, leaking of blood and result in a well formed pulsatile hematoma. This is a very crucial problem by the exponential growth of drug addiction.
Methods: A prospective clinical trial study over a period of 20 months, 22 patients were attended complaining of a local pulsatile swelling at different site of recurrent drug injection and involved in this study. Antegrade or retrograde approach used depending on the site of the pseudoaneurysm and feeding neck. Excluded from study any patient presented with signs of infection or bleeding or treated by other method.
Results: 22 patients, 20 were males and 2 were females. Age was 31.2 + 9.2 in years. The incidence of traumatic pseudo aneurysm between 15 - 25 years old (45.5% of our cases ). the most common site forming pseudoaneurysm the groin (femoral artery), the antecubital region (brachial artery) and carotid artery (11) 44%, (8) 32% and 3 (12%) respectively. Management by endovascular covered stent may with different complications post intervention like 4.5% (one patient) thrombosis on brachial artery, endo-leak of the femoral artery ( one patient) and all managed with no residual complication and all patients passed well.
Conclusion: endovascular intervention using covered stent to close the feeding neck, with less controllable complications and less hospitalization time.
Key words: endovascular, pseudoaneurysm, covered stent and endo-leak.