Department of General, Federico II University of Naples, Via S Pansini 5, 80131 Naples, Italy.
Eur J Vasc Endovasc Surg. 2010 May;39(5):565-8. doi: 10.1016/j.ejvs.2009.12.010. Epub 2010 Feb 1.
Anastomotic pseudoaneurysm following renal transplantation is uncommon. Indications for repair, treatment options and outcomes remain controversial.
We present 6 renal transplant recipients with large anastomotic pseudoaneurysms. Five of the patients underwent open repair while one had a stent-grafting and delayed transplant nephrectomy for a ruptured pseudoaneurysm. A transplant nephrectomy was needed in all cases but one. Arterial reconstruction enabled limb salvage in all cases. One patient died of sepsis postoperatively. No patient presented late infection, failure of vascular reconstruction, nor pseudoaneurysm recurrence.
Surgical excision of anastomotic pseudoaneurysms results in high rates of allograft loss. Less invasive techniques have a place in selected cases.
肾移植后吻合口假性动脉瘤并不常见。修复的适应证、治疗选择和结果仍存在争议。
我们报告了 6 例肾移植受者存在大的吻合口假性动脉瘤。5 例患者接受了开放修复，1 例因破裂的假性动脉瘤行支架置入和延迟移植肾切除术。所有患者均需要行移植肾切除术，但有 1 例患者除外。动脉重建使所有患者肢体得以保留。1 例患者术后死于败血症。无患者出现晚期感染、血管重建失败或假性动脉瘤复发。
手术切除吻合口假性动脉瘤会导致移植物丢失率高。在某些情况下，微创技术有其应用的一席之地。
