Agrifoglio G, Costantini A, Lorenzi G, Agus G B, Castelli P M, Zaretti D
Institute of Vascular Surgery and Angiology, University of Milan, Italy.
J Cardiovasc Surg (Torino). 1990 Jul-Aug;31(4):453-6.
Fifty-six femoral non infected anastomotic false aneurysms (FAAs) were observed in 49 patients admitted to the Institute of Vascular Surgery, University of Milan, from 1975 to 1988; in 6 patients they were bilateral. These aneurysms developed after primary revascularization procedures at a mean interval of 66 months (range 12 to 156 months); one recurred after reparative surgery. Forty-four FAAs (78.6%) were asymptomatic, whereas 3 (5.3%) were complicated by acute expansion and 9 (16.1%) by thrombosis. Host vessel degeneration was the cause of aneurysm formation in most cases. A history of hypertension was present in 30% of the patients. All anastomotic aneurysms were operated upon except for one small aneurysm that was asymptomatic. In 5 patients aneurysm resection was carried out on both sides. The surgical technique was endoaneurysmectomy in all the cases with insertion of an interposition graft in 48 cases, a fabric patch in 2 cases and prosthesis re-anastomosis in 5 cases. One case of peripheral embolization occurring in the early postoperative period was successfully treated and there was no operative mortality. In our opinion elective repair of these aneurysms should be recommended whenever possible because of their propensity to develop serious complications and the operative morbidity is low.
1975年至1988年期间，米兰大学血管外科研究所收治的49例患者中观察到56例股部非感染性吻合口假性动脉瘤（FAA）；其中6例为双侧病变。这些动脉瘤在初次血管重建术后发生，平均间隔时间为66个月（范围12至156个月）；1例在修复手术后复发。44例FAA（78.6%）无症状，而3例（5.3%）并发急性扩张，9例（16.1%）并发血栓形成。大多数情况下，宿主血管退变是动脉瘤形成的原因。30%的患者有高血压病史。除1例无症状小动脉瘤外，所有吻合口动脉瘤均接受了手术治疗。5例患者双侧均进行了动脉瘤切除术。所有病例均采用动脉瘤内切除术，48例植入了间置移植物，2例植入了织物补片，5例进行了假体再吻合。1例术后早期发生的周围栓塞病例得到成功治疗，无手术死亡病例。我们认为，鉴于这些动脉瘤易于发生严重并发症且手术发病率较低，应尽可能建议对其进行择期修复。
