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大腿巨大创伤性假性动脉瘤的血管内与外科联合修复——病例报告

Combined endovascular and surgical repair of a large traumatic pseudoaneurysm of the thigh-a case report.

作者信息

Costanza Michael J, Neschis David G, Flinn William R

机构信息

Division of Vascular Surgery, University of Maryland Medical Center, Baltimore, MD, USA.

出版信息

Vasc Endovascular Surg. 2005 Jan-Feb;39(1):117-20. doi: 10.1177/153857440503900113.

DOI:10.1177/153857440503900113
PMID:15696256
Abstract

Thigh pseudoaneurysms are rare compared to pseudoaneurysms of the groin, and usually result from direct injury to an arterial branch. Direct open repair can be associated with a large volume blood loss. The authors describe a combined endovascular and surgical approach to a large, traumatic, pseudoaneurysm of the thigh. The patient was a 49-year-old man with a history of left femur fracture treated by open reduction and internal fixation, who presented with a painfully swollen left thigh. Duplex ultrasound and computed tomography (CT) scan suggested a large (7.7 x 5.0 x 6.3 cm) pseudoaneurysm that appeared to be associated with a branch of the deep femoral artery. In the operating room, angiography was used to identify and selectively access the feeding artery. This artery was then successfully coil embolized, allowing surgical decompression of the thigh with minimal effort and blood loss. Endovascular and surgical therapy were complementary in successfully treating a large traumatic pseudoaneurysm of the thigh.

摘要

与腹股沟假性动脉瘤相比,大腿假性动脉瘤较为罕见,通常由动脉分支的直接损伤引起。直接开放修复可能会导致大量失血。作者描述了一种针对大腿巨大创伤性假性动脉瘤的血管内和外科联合治疗方法。患者为一名49岁男性,有左股骨骨折切开复位内固定病史,现出现左大腿疼痛性肿胀。双功超声和计算机断层扫描(CT)显示一个巨大的(7.7×5.0×6.3厘米)假性动脉瘤,似乎与股深动脉的一个分支有关。在手术室中,血管造影用于识别并选择性地进入供血动脉。然后成功地用弹簧圈栓塞该动脉,使大腿以最小的努力和失血进行手术减压。血管内治疗和手术治疗在成功治疗大腿巨大创伤性假性动脉瘤方面具有互补性。

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