Kotval P S, Khoury A, Shah P M, Babu S C
Department of Radiology, New York Medical College, Valhalla.
J Ultrasound Med. 1990 Apr;9(4):185-90. doi: 10.7863/jum.1990.9.4.185.
In three patients with diagnosed pseudoaneurysms, surgical intervention was delayed because of the patients' clinical condition. In successive follow-up examinations in one patient, development of a new lobe to the previously single-lobed pseudoaneurysm was noted with progressive centripetal thrombus formation in each lobe leading to the eventual complete thrombosis of the pseudoaneurysm without surgical intervention. The sequence of steps leading to the complete thrombosis of the pseudoaneurysm as seen by color Doppler and pulsed Doppler examination is described. In two other patients with a single-lobed and a multilobed pseudoaneurysm, respectively, follow-up examinations without surgical management revealed complete thrombosis of the pseudoaneurysms. Whereas traditional teaching holds that pseudoaneurysms require surgical repair, this short series of cases suggests that, when progressive centripetal thrombus formation is observed, the pseudoaneurysms can go on to complete thrombosis. Follow-up for up to 4 months reveals no sonographic evidence of rebleeding or other evidence of weakness in the arterial wall at the site of the previous pseudoaneurysms.
在3例已确诊为假性动脉瘤的患者中，由于患者的临床状况，手术干预被推迟。在对1例患者进行的连续随访检查中，发现先前单叶假性动脉瘤出现了一个新叶，每个叶内均有向心性血栓形成，并逐渐发展，最终在未进行手术干预的情况下假性动脉瘤完全血栓形成。本文描述了通过彩色多普勒和脉冲多普勒检查观察到的假性动脉瘤完全血栓形成的步骤顺序。另外2例患者分别患有单叶和多叶假性动脉瘤，未经手术处理的随访检查显示假性动脉瘤完全血栓形成。传统观点认为假性动脉瘤需要手术修复，但这一小系列病例表明，当观察到向心性血栓形成进展时，假性动脉瘤可继续发展至完全血栓形成。长达4个月的随访显示，超声检查未发现再出血迹象或先前假性动脉瘤部位动脉壁存在其他薄弱迹象。
