Soumer K, Benomrane S, Derbel B, Laribi J, Benmrad M, Elleuch N, Kalfat T, Khayati A
Department of Cardiovascular Surgery, La Rabta Hospital, College of Medicine, University of Tunis El Manar, Tunis, Tunisia.
J Mal Vasc. 2015 Feb;40(1):58-62. doi: 10.1016/j.jmv.2014.11.001. Epub 2015 Jan 23.
Most popliteal arteriovenous fistula and pseudoaneurysm formation are related to trauma. Few cases have previously been reported after acupuncture therapy. Such events are typically observed when the procedure is performed by non-medical acupuncturist. They may present with acute ischemia, recent claudication, distal emboli, or less commonly rupture. Duplex ultrasound should be considered as the 1st method of investigation. Computed tomography scanning is particularly accurate in making the diagnosis. Treatment strategies consist of surgery or endovascular management. The most commonly performed surgical technique for popliteal pseudoaneurysm repair is resection with bypass grafting, whereas popliteal arteriovenous fistula are usually treated surgically with ligation and primary repair. Endovascular procedure using a stent-graft is thought to be a reasonable option for treating popliteal false aneurysm or even arteriovenous fistula. We will describe two cases of an arteriovenous fistula and pseudoaneurysm of the popliteal artery that developed after acupuncture needling in the region of the popliteal artery.
大多数腘动脉动静脉瘘和假性动脉瘤的形成与创伤有关。此前仅有少数几例针刺治疗后发生此类情况的报道。此类事件通常在由非医学针灸师进行操作时出现。患者可能表现为急性缺血、近期间歇性跛行、远端栓子，或较少见的破裂。应将双功超声视为首要的检查方法。计算机断层扫描在诊断方面尤为准确。治疗策略包括手术或血管腔内治疗。腘动脉假性动脉瘤修复最常用的手术技术是切除并进行旁路移植，而腘动脉动静脉瘘通常通过手术结扎和一期修复进行治疗。使用覆膜支架的血管腔内手术被认为是治疗腘动脉假性动脉瘤甚至动静脉瘘的合理选择。我们将描述两例在腘动脉区域针刺后发生的腘动脉动静脉瘘和假性动脉瘤病例。
