Gopal Ambarish, Aranson Nathan, Woo Karen, Clavijo Leonardo, Shavelle David M
Division of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
Cardiovasc Revasc Med. 2013 Nov-Dec;14(6):359-62. doi: 10.1016/j.carrev.2013.04.005. Epub 2013 May 14.
Pseudoaneurysms (PAs) of arteries in the lower extremities are uncommon. In most cases, a PA of the common femoral artery develops following percutaneous access and treatment with ultrasound guided thrombin injection achieves success rates approaching 98%. In contrast, the management of a PA of the distal leg vessels is more complex and may require additional endovascular and/or surgical treatments. We present a case of a recalcitrant PA involving the distal peroneal artery that developed following blunt trauma in a patient with Hemophilia B who failed ultrasound guided thrombin injection, para-aneurysmal saline injection and required two coil embolization procedures. Our observations suggest that Factor IX supplementation combined with aggressive coil embolization is the most effective treatment approach.
下肢动脉假性动脉瘤（PA）并不常见。在大多数情况下，股总动脉PA在经皮穿刺后形成，超声引导下注射凝血酶治疗的成功率接近98%。相比之下，小腿远端血管PA的处理更为复杂，可能需要额外的血管内和/或手术治疗。我们报告一例难治性PA累及腓骨远端动脉，该患者为乙型血友病，钝性创伤后发病，超声引导下注射凝血酶、瘤周注射生理盐水均失败，需要进行两次弹簧圈栓塞术。我们的观察结果表明，补充凝血因子IX联合积极的弹簧圈栓塞是最有效的治疗方法。
