Anastomotic false aneurysms

Between 1961 and 1970, 19 patients who developed a total of 37 false aneurysms were seen and treated at this hospital. Three of the 19 patients had an infection associated with the aneurysm formation, which occurred in these patients at a mean time of two months after their initial vascular surgery. The mean time interval in the non-infected patients was five years, ten months, with a range of from one to nine years. Sixty-three percent of the patients had more than one anastomotic aneurysm, either discovered incidentally at the time of their initial presentation or discovered on subsequent admissions. Three patients in this series died as a result of attempts to correct their anastomotic disruptions. Intraoperative rupture of a second unsuspected anastomotic aneurysm was the major factor in two of these deaths. Amputation was necessary in three other patients, while the remaining 13 patients were treated successfully. Thirty-six of the 37 aneurysms occurred at anastomoses constructed with silk sutures. It is, therefore, concluded that late failure of silk sutures is the major factor in anastomotic aneurysm formation.