Bikk Andras, Rosenthal Martin D, Wellons Eric D, Hancock Susan M, Rosenthal David
Department of Vascular Surgery, Atlanta Medical Center, Atlanta, GA, USA.
Vascular. 2006 May-Jun;14(3):173-6. doi: 10.2310/6670.2006.00022.
Saphenous vein is the most widely used conduit for arterial bypass procedures and aneurysms of the vein graft are rare. We report a true aneurysm of a reversed femoropopliteal saphenous vein graft implanted nine years earlier. Duplex ultrasonography identified an aneurysm of the saphenous vein graft and arteriography confirmed this finding. A consideration for endovascular coiling of the aneurysm was entertained, but no proximal "neck" on the aneurysm was present. The patient, therefore, underwent an uneventful resection of the aneurysm with end-to-end anastomosis. Histopathologic examination of the aneurysm demonstrated atherosclerotic degeneration with endothelial disruption, medial necrosis, and fibrous proliferation. The cause of a saphenous vein graft aneurysm is rare and unknown. The management of vein graft aneurysms, however, should be subject to the same criteria that apply to other aneurysms because once vein graft dilation occurs, it is followed by a rapid increase in size, which may lead to possible rupture.
隐静脉是动脉搭桥手术中使用最广泛的血管 conduit，静脉移植物的动脉瘤很少见。我们报告一例9年前植入的逆行股腘隐静脉移植物的真性动脉瘤。双功超声检查发现隐静脉移植物有动脉瘤，动脉造影证实了这一发现。曾考虑对动脉瘤进行血管内栓塞，但动脉瘤上没有近端“颈部”。因此，患者接受了动脉瘤的顺利切除并进行了端端吻合。动脉瘤的组织病理学检查显示动脉粥样硬化退变，伴有内皮破坏、中层坏死和纤维增生。隐静脉移植物动脉瘤的病因罕见且不明。然而，静脉移植物动脉瘤的处理应遵循适用于其他动脉瘤的相同标准，因为一旦静脉移植物扩张发生，其大小会迅速增加，这可能导致破裂。
