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Nigerian Journal of Medicine

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The Challenges Facing the Management of Arterial Aneurysm in UNTH, Enugu

IA Nwafor, JC Ezer, N Ezemba, CH Anyanwu

Abstract


BACKGROUND: The management of arterial aneurysm either central or peripheral has undergone evolution over the past decades. We encounter both true and pseudo aneurysm on regular basis with its complications.
OBJECTIVE: To assess the challenges of managing arterial aneurysm at UNTH, Enugu in view of the health implications of the condition.
METHOD: Medical records of all patients with documented arterial aneurysm over a 5-year period (2007-2011) were reviewed. Data collected and documented included patients' demographics, type of vessels  involved, investigative tools used in confirming the diagnosis, type of treatment, outcome and length of hospital stay.
RESULT: A total of 37 patients were managed for arterial aneurysm during the period under review. These consisted of 24 males (64.9%) and 13 females (35.2%). Age range  was 11-78 years with a mean of 2.4 years. Central aneurysms involved ascending, arch and descending aorta as well as abdominal aorta. Peripheral ones affected femoral, axillary, brachial, and popliteal artery. The central aneurysms with the exception of abdominal aortic aneurysms were managed conservatively. Those that failed conservative management were referred to centres with expertise and facilities for on pump surgery. The peripheral ones in addition to abdominal aortic aneurysms were managed operatively with good outcome.  The challenges identified in the management included non-availability of on pump expertise and prosthesis, late presentation of patients, under utilisation of CT and or MRI, poor compliance to antihypertensive drugs and poor follow up.
CONCLUSION: Intervention in arterial aneurysms is the gold standard but not yet easily available and affordable at this centre. The challenges that have been identified are real and need to be addressed in order to deliver optimal care to patients within our domain. Efforts are underway in tackling them.



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