Klonaris Chris, Katsargyris Athanasios, Matthaiou Alexandros, Giannopoulos Athanasios, Tsigris Chris, Papadopouli Katerina, Tsiodras Sotiris, Bastounis Elias
1st Department of Surgery, Vascular Division, LAIKON Hospital, Athens University Medical School, 17 Ag. Thoma Street, 11527 Athens, Greece.
Cardiovasc Intervent Radiol. 2007 Nov-Dec;30(6):1238-41. doi: 10.1007/s00270-007-9080-z. Epub 2007 May 22.
A 74-year-old man presented with a ruptured infected anastomotic femoral pseudoaneurysm. Due to severe medical comorbidities he was considered unsuitable for conventional surgical management and underwent an emergency endovascular repair with a balloon-expandable covered stent. The pseudoaneurysm was excluded successfully and the patient had an uneventful postoperative recovery with long-term suppressive antimicrobials. He remained well for 10 months after the procedure with no signs of recurrent local or systemic infection and finally died from an acute myocardial infarction. To our knowledge, emergency endovascular treatment of a free ruptured bleeding femoral artery pseudoaneurysm has not been documented before in the English literature. This case illustrates that endovascular therapy may be a safe and efficient alternative in the emergent management of ruptured infected anastomotic femoral artery pseudoaneurysms when traditional open surgery is contraindicated.
一名74岁男性因感染性股动脉吻合口假性动脉瘤破裂就诊。由于存在严重的内科合并症，他被认为不适合传统手术治疗，遂接受了球囊扩张型覆膜支架的急诊血管内修复术。假性动脉瘤被成功隔绝，患者术后恢复顺利，并接受了长期抑菌性抗菌治疗。术后10个月他情况良好，无局部或全身感染复发迹象，最终死于急性心肌梗死。据我们所知，英文文献中此前尚无关于游离性破裂出血的股动脉假性动脉瘤急诊血管内治疗的记载。该病例表明，当传统开放手术禁忌时，血管内治疗可能是感染性股动脉吻合口假性动脉瘤破裂急诊处理中的一种安全有效的替代方法。
