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创伤后腹主动脉瘤血栓栓塞导致急性肢体缺血的挑战。

The challenge of posttraumatic thrombus embolization from abdominal aortic aneurysm causing acute limb ischemia.

机构信息

Department of Surgery, Ospedale Civico di Lugano, Lugano, Switzerland.

出版信息

J Vasc Surg. 2011 Sep;54(3):840-3. doi: 10.1016/j.jvs.2011.01.051. Epub 2011 Apr 8.

Abstract

We report the first documented case of distal thromboembolism originating from an abdominal aortic aneurysm (AAA) after a blunt trauma. A 72-year-old man with a known 6.2 cm AAA was brought to our emergency department with signs of bilateral acute limb ischemia developing immediately after an accidental fall. The occlusion was confirmed at computed tomographic angiography, and the aneurysm showed a fragmentated/ulcerated mural thrombus, morphologically different as compared to the previous computed tomography (CT). A thromboembolectomy was performed and, after treatment of the ischemic complications, the aneurysm was repaired by open surgery. Embolization from aneurysms in the setting of a trauma is a challenge for the vascular surgeon, also because of its rare occurrence. We describe the management and discuss the operative strategy we opted for in this patient.

摘要

我们报告了首例钝性创伤后源自腹主动脉瘤(AAA)的远端血栓栓塞病例。一名 72 岁男性,已知患有 6.2cm 的 AAA,在意外跌倒后立即出现双侧急性肢体缺血的迹象,被送往我们的急诊部。计算机断层血管造影术(CTA)确认了闭塞,动脉瘤显示出碎裂/溃疡性血栓,与之前的 CT 相比形态不同。进行了血栓切除术,在治疗缺血性并发症后,通过开放手术修复了动脉瘤。创伤环境中的动脉瘤栓塞对血管外科医生来说是一个挑战,也因为其罕见发生。我们描述了该患者的治疗方法,并讨论了我们选择的手术策略。

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