Background: Pseudoaneurysm (PSA), or false aneurysm, is a local dilation or rupture of a blood vessel caused by a breach in arterial wall not contained by layers of the normal arterial wall. Arterial ligation is a reliable and efficient technique, with a limited number of individuals requiring significant amputations. The present work aims to improve outcomes of surgical management of patients with infected femoral PSA.

Subjects and methods: This is a prospective clinical trial investigation which was conducted on intravenous drug addict patients with femoral PSA admitted to the emergency unit of the vascular surgery department in Zagazig University Hospital. During the study period (6 months), 3 cases/month, 18 cases were included. All cases were subjected to complete history taking, and full general and local examination for the lower limb regarding bleeding, oedema, state of skin and soft tissue, distal pulsations and other signs of ischemia. All cases got intravenous broad-spectrum antibiotics before surgery, which lasted throughout the period after surgery with antibiotics indicated by culture findings.

Results: There was a highly substantial reduction in O2 Saturation in ligated limbs among amputated cases compared to non. There was a remarkable elevation in frequency of pain, coldness, colour change, delayed and absent capillary filling, and affected and loss of motor and sensory among amputated cases compared to non.

Conclusion: PSA excision, arterial ligation, and debridement of contaminated tissue are all successful first-line treatments with extremely low major adverse limb events. We advise against vascular repair because ofincreased risk of infection