Siani A, Accrocca F, Giordano G A, Antonelli R, Mounayergi F, Gabrielli R, Siani L M, Baldassarre E, Marcucci G
Division of Vascular Surgery, S. Paolo Hospital ASL RMF, Civitavecchia, Rome.
G Chir. 2007 Nov-Dec;28(11-12):443-5.
We report a case of acute embolic ischemia of the right lower limb in a patient with unexpected intraoperative anatomic variant of femoral artery. In this anomaly, the deep femoral artery arises from the external iliac artery, 2 cm above the inguinal ligament, runs with a parallel course with the superficial femoral artery, and placed between the branches of femoral nerve. In consideration of the difficulty to achieve extensive and optimal control of the external iliac artery with the femoral approach, a retrograde embolectomy of the iliac artery by two separate arteriotomies on the deep and superficial femoral arteries were successfully performed. The literature reviewed about this anomalies. In these unexpected intraoperative cases a ductile and ingenious approach seems to be mandatory to perform a safe operation with low systemic impact.
我们报告了一例右下肢急性栓塞性缺血患者，该患者术中出现意外的股动脉解剖变异。在这种异常情况中，股深动脉起源于腹股沟韧带上方2cm处的髂外动脉，与股浅动脉平行走行，并位于股神经分支之间。考虑到经股入路难以充分且最佳地控制髂外动脉，通过在股深动脉和股浅动脉分别进行动脉切开术，成功实施了逆行髂动脉取栓术。回顾了关于这种异常情况的文献。在这些意外的术中病例中，采用灵活巧妙的方法似乎对于进行安全且对全身影响较小的手术必不可少。
