Clark E T, Mass D P, Bassiouny H S, Zarins C K, Gewertz B L
Department of Surgery, University of Chicago, Illinois 60637.
Ann Vasc Surg. 1991 May;5(3):276-81. doi: 10.1007/BF02329386.
Ten patients with true aneurysmal disease of the hand and forearm vessels were treated at our institution between 1981 and 1990. Pseudoaneurysms resulting from penetrating trauma or mycotic aneurysms were specifically excluded. Eight patients were male, two were female; mean patient age was 38 years (range 26 to 72 years). A history of repetitive occupational or recreational trauma was elicited in five patients. All patients presented with painful masses or neurologic symptoms due to nerve compression. Ischemic changes were evident in five patients due to thrombosis or distal embolization. Arteriography and transcutaneous Doppler ultrasound aided in documentation of flow characteristics and planning for operative intervention. Three patients underwent excision and ligation once collateral flow was demonstrated to be adequate and reconstruction was not felt to be feasible. Seven patients underwent resection with vein graft reconstruction. Immediate postoperative and interval patency rates were 100%. No digital amputations were required even in those patients presenting with severe distal ischemia.
1981年至1990年间，我院共治疗了10例手部和前臂血管真性动脉瘤患者。穿透性创伤所致假性动脉瘤或霉菌性动脉瘤患者被特意排除在外。8例为男性，2例为女性；患者平均年龄为38岁（范围26至72岁）。5例患者有重复性职业或娱乐性创伤史。所有患者均因神经受压出现疼痛性肿块或神经症状。5例患者因血栓形成或远端栓塞出现缺血性改变。动脉造影和经皮多普勒超声有助于记录血流特征并为手术干预制定计划。3例患者在证实侧支血流充足且认为重建不可行后，接受了切除和结扎手术。7例患者接受了静脉移植重建切除术。术后即刻通畅率和随访通畅率均为100%。即使是那些有严重远端缺血的患者也无需进行手指截肢。
