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腋动脉动脉瘤的外科治疗。

Surgical treatment of axillary artery aneurysm.

作者信息

Tetik Omer, Yilik Levent, Besir Yuksel, Can Aynur, Ozbek Cengiz, Akcay Ayhan, Gurbuz Ali

机构信息

Department of Cardiovascular Surgery, Ataturk Education and Research Hospital, Yesilyurt, Izmir, Turkey.

出版信息

Tex Heart Inst J. 2005;32(2):186-8; discussion 185.

Abstract

Aneurysms of the axillary artery are rare and dangerous lesions that threaten the upper extremities with vascular and neurologic compromise. Most can be treated effectively with surgical excision and vascular grafting. We retrospectively assessed 4 axillary artery aneurysms upon which we operated from February 1998 through March 2004. Three patients were admitted to our clinic for symptomatic axillary masses. The remaining patient was transported to our clinic emergently due to massive hemorrhage of an enlarging axillary mass that occurred during biopsy of the mass at another hospital. In this patient, the ruptured axillary artery aneurysm was diagnosed by means of emergent upper-extremity selective angiography. All patients were treated surgically by means of aneurysmectomy and graft interpositioning--with polytetrafluoroethylene grafts in 2 patients and saphenous vein grafts in the other 2. Surgical treatment of axillary artery aneurysms is of importance in avoiding thromboembolism and ischemia, which in turn can lead to gangrene and amputation of the affected extremity. For this reason, operative management of such cases should not be delayed.

摘要

腋动脉动脉瘤是罕见且危险的病变,会因血管和神经功能受损而威胁上肢。大多数可通过手术切除和血管移植有效治疗。我们回顾性评估了1998年2月至2004年3月间我们手术治疗的4例腋动脉动脉瘤。3例患者因有症状的腋部肿块入住我院。其余1例患者因在另一家医院对增大的腋部肿块进行活检时出现大量出血而紧急转至我院。在该患者中,通过紧急上肢选择性血管造影诊断出破裂的腋动脉动脉瘤。所有患者均接受了动脉瘤切除术和移植血管置入术进行手术治疗,其中2例使用聚四氟乙烯移植血管,另外2例使用大隐静脉移植血管。腋动脉动脉瘤的手术治疗对于避免血栓栓塞和缺血至关重要,而这反过来又可能导致坏疽和受影响肢体的截肢。因此,对此类病例的手术处理不应延迟。

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