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1例细菌性心内膜炎患者的臀上动脉霉菌性动脉瘤:病例报告及文献复习

Mycotic aneurysm of the superior gluteal artery in a patient with bacterial endocarditis: case report and review of the literature.

作者信息

Fujimura Naoki, Obara Hideaki, Matsumoto Kenji, Kitagawa Yuko

机构信息

Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.

出版信息

Vascular. 2011 Feb;19(1):47-50. doi: 10.1258/vasc.2010.cr0225.

Abstract

Mycotic aneurysm of the superior gluteal artery (SGA) is extremely rare. The review of the literature revealed only five cases of mycotic SGA aneurysms reported to date and none had a concomitant superior mesenteric artery (SMA) aneurysm. We describe a 64-year-old man with mycotic aneurysms of both the SGA and the SMA. The patient was referred to our hospital because of SMA embolism caused by bacterial endocarditis following mitral valve plasty. He was treated conservatively, but monitoring using computerized tomography (CT) scanning showed the development and growth of the SGA and the SMA aneurysms. The SMA aneurysm was resected surgically, and the SGA lesion was treated by means of selective embolization. For the treatment of SGA aneurysms, prompt and precise preoperative evaluation is important. When the anatomical feature and size of the aneurysm is suitable, endovascular treatment may be the first-line treatment, providing an efficacious and safe alternative to traditional surgical repair.

摘要

臀上动脉(SGA)霉菌性动脉瘤极为罕见。文献回顾显示,迄今为止仅报道过5例霉菌性SGA动脉瘤,且均无合并肠系膜上动脉(SMA)动脉瘤的情况。我们描述了一名64岁男性,其同时患有SGA和SMA霉菌性动脉瘤。该患者因二尖瓣成形术后细菌性心内膜炎导致SMA栓塞而转诊至我院。他接受了保守治疗,但计算机断层扫描(CT)监测显示SGA和SMA动脉瘤不断发展和增大。SMA动脉瘤接受了手术切除,SGA病变则通过选择性栓塞进行治疗。对于SGA动脉瘤的治疗,术前迅速而精确的评估至关重要。当动脉瘤的解剖特征和大小合适时,血管内治疗可能是一线治疗方法,为传统手术修复提供了一种有效且安全的替代方案。

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