Bilateral mycotic axillary artery false aneurysms in an intravenous drug user: unsuspected broken needle-tips pose a risk to the treating personnel

Eur J Vasc Surg. 1992 Jul;6(4):434-7. doi: 10.1016/s0950-821x(05)80295-6.

Abstract

Mycotic false aneurysms due to local arterial injury from attempted intravenous injections in drug addicts are increasing in frequency. The high incidence of HIV and hepatitis B virus in parenteral drug users may present a considerable risk to the treating personnel. This paper reports the unsuspected presence of broken needle-tips in the subcutaneous tissues of an intravenous drug abuser, in association with bilateral mycotic aneurysms of the axillary arteries. Broken needle-tips have the potential to cause needlestick injury to the operating team and the nursing staff, with the associated risk of transmission of HIV and hepatitis B virus infection. The presence of broken needle-tips should be suspected in drug users presenting with false aneurysms associated with local arterial injection injury and a specific history of needle-breakage should be sought. Preoperative plain radiographs should be performed of the planned operative field to exclude the presence of such needle-tips. Any soft tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being a false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, Infected / diagnostic imaging
  • Aneurysm, Infected / surgery*
  • Axillary Artery / diagnostic imaging
  • Axillary Artery / injuries*
  • Axillary Artery / surgery
  • Foreign Bodies / complications*
  • Foreign Bodies / diagnostic imaging
  • Foreign Bodies / surgery
  • Humans
  • Male
  • Needles*
  • Needlestick Injuries / diagnostic imaging
  • Needlestick Injuries / etiology*
  • Occupational Diseases / etiology*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery
  • Radiography
  • Reoperation
  • Risk Factors
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / diagnostic imaging