Westmead Hospital, University of Sydney Medical School, Sydney, NSW 2145, Australia.
Prog Cardiovasc Dis. 2013 Jul-Aug;56(1):36-56. doi: 10.1016/j.pcad.2013.06.001. Epub 2013 Jul 23.
Peripheral arterial aneurysms are uncommon; for some aneurysm types, data are limited to case reports and small case series. There is no Level A evidence in most cases to determine the choice between open or endovascular intervention. The evolution of endovascular technology has vastly improved the armamentarium available to the vascular surgeon and interventionalists in the management of these rare and unusual aneurysms. The choice of operative approach will ultimately be determined on an individual basis, dependent on the patient risk factors, and aneurysm anatomy. After consideration, some aneurysms (femoral, subclavian, carotid and ECAA) fare better with an open first approach; renal, splenic and some visceral artery aneurysms do better with an endovascular first approach. In our practice PAAs are treated with an endovascular first approach. For these rare conditions, both open and endovascular therapy will continue to work in harmony to enhance and extend the capabilities of modern surgical management.
外周动脉动脉瘤并不常见；对于某些类型的动脉瘤，数据仅限于病例报告和小病例系列。在大多数情况下，没有 A 级证据来确定开放手术与血管内介入治疗之间的选择。血管外科医生和介入放射学家在管理这些罕见和不寻常的动脉瘤时，腔内技术的发展极大地丰富了可用的治疗手段。手术方法的选择最终将根据患者的危险因素和动脉瘤解剖结构进行个体化决定。经过考虑，一些动脉瘤（股动脉、锁骨下动脉、颈动脉和 ECAA）采用开放手术治疗效果更好；而肾动脉、脾动脉和一些内脏动脉动脉瘤则采用血管内介入治疗效果更好。在我们的实践中，PAAs 采用血管内介入治疗。对于这些罕见的疾病，开放手术和血管内治疗将继续协同工作，以增强和扩展现代外科管理的能力。
