Surgical treatment of patients with peripheral artery pseudoaneurysm in a field hospital within Special Military Operation

Aim. To analyze the results of surgical treatment of patients with peripheral artery pseudoaneurysmf after shrapnel wounds in a field hospital within Special Military Operation. Material and methods. From February 1, 2025 to July 1, 2025, 15 reconstructive surgeries for post-traumatic peripheral artery aneurysms were performed. All patients were men under 44 years of age. The time of aneurysm diagnostics always exceeded 21 days due to the absence of its specific symptoms. In 73,3% of cases, bleeding developed during injury, which was stopped by applying a compression bandage or tourniquet. In 19,5±3,5 days after injury, as a result of aneurysm growth, progression of perivascular edema and inflammation, symptoms of peripheral neuropathy appeared in 80% of cases.

Results. In 80%, the pseudoaneurysm diameter reached 3-5 cm. In all cases, mural thrombosis of its cavity was determined. In 1 patient, arteriovenous fistula was detected. There were following pseudoaneurysm locations: axillary artery — 26,7%, brachial artery — 20%, popliteal artery — 13,3%, posterior tibial artery — 13,3%, superficial femoral artery — 13,3%, radial artery — 6,7%, deep femoral artery — 6,7%. In 53,3%, autovenous grafting with reversed great saphenous vein was performed, while in 46,7% — artery section resection with end-to-end anastomosis. In all cases, no complications were recorded. After 19,5±2,5 days after the intervention, neuropathy regressed in 7 out of 12 patients. Patients with remaining neurological symptoms were evacuated to the next stages of rehabilitation. The rest returned to military service.

Conclusion. In a shrapnel wound of the extremities, vessel ultrasound should be routinely performed in order to search for signs of an asymptomatic pseudoaneurysm. The choice of surgical technique should always be individualized, taking into account the lesion topography. A pronounced cicatrization and close location of peripheral nerves create technical difficulties in isolating arteries and removing an aneurysm.

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