Outcomes of open surgical interventions for pseudoaneurysms: A 5-year retrospective study at 2 referral hospitals in Addis Ababa, Ethiopia

Abstract

Background

A pseudoaneurysm is a rupture in an arterial wall resulting from inflammation, trauma, or an iatrogenic mechanism. The epidemi­ology and treatment outcomes of pseudoaneurysms remain unclear in resource-limited settings, such as Ethiopia, where open surgical repair is the primary method of treatment.

Methods

In this retrospective medical record review, eligible patients were those treated for pseudoaneurysms at 2 large hospitals in Addis Ababa from 1 January 2015 through 31 December 2019. Descriptive statistics were generated to characterize the patient popu­lation.

Results

The medical records of 76 patients were reviewed. Most patients were male (n=63, 83%) and less than 31 years old (n=43, 57%). Trauma was the most common cause of pseudoaneurysm formation (n=63, 83%), with stab and gunshot wounds being the leading causes. Swelling (n=68, 89%), pain (n=62, 82%), and pulsatile mass (n=55, 72%) were the leading presenting symptoms. The most common vessel affected by pseudoaneurysm formation was the superficial femoral artery. All patients underwent open surgical repair; interposition grafting was performed for 24 patients (32%). Three patients underwent repeat surgery. The rate of surgical site infection was 22%. Significant intraoperative bleeding occurred in 6 of the index procedures (8%).

Conclusions

In contrast to other settings, trauma was the most common cause of pseudoaneurysms in our study. Swelling, pulsatile mass, and pain were the predominant clinical presentations. Surgical site infections were common, and this finding warrants further investigation.