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一名接受血管腔内腹主动脉瘤修复术的患者在全髋关节置换术后出现对侧急性下肢缺血。

Contralateral acute lower limb ischaemia following total hip replacement in a patient with an endovascular abdominal aortic aneurysm repair.

作者信息

Brookes-Fazakerley Steven D, Thorpe Philippa, Chan Colin, Jackson Gillian E

机构信息

Wirral University Teaching Hospital NHS Foundation Trust, Wirral, Merseyside, UK

Wirral University Teaching Hospital NHS Foundation Trust, Wirral, Merseyside, UK.

出版信息

J Surg Case Rep. 2015 Mar 4;2015(3):rjv007. doi: 10.1093/jscr/rjv007.

DOI:10.1093/jscr/rjv007
PMID:25742966
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4349996/
Abstract

Total hip replacement (THR) is a common procedure to treat patients with a fractured neck of femur. Ipsilateral major vessel injury with acute lower limb ischaemia is a rare but potentially devastating complication. Contralateral acute limb ischaemia is unreported. We present the case of a contralateral, acute lower limb ischaemia following THR for a fractured neck of femur in the presence of an endovascular aortic aneurysm repair (EVAR) and femoro-femoral crossover grafts. We advise early vascular surgery consultation for patients undergoing THR with an EVAR stentgraft in situ to help minimize risks of peri- and postoperative graft occlusion and consequent acute lower limb ischaemia.

摘要

全髋关节置换术（THR）是治疗股骨颈骨折患者的常见手术。同侧主要血管损伤伴急性下肢缺血是一种罕见但可能具有毁灭性的并发症。对侧急性肢体缺血尚无报道。我们报告了一例在进行血管内主动脉瘤修复（EVAR）和股-股交叉移植的情况下，因股骨颈骨折行THR后出现对侧急性下肢缺血的病例。我们建议，对于原位植入EVAR支架移植物并接受THR的患者，应尽早咨询血管外科医生，以帮助将围手术期和术后移植物闭塞及随之而来的急性下肢缺血风险降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/7752e549ee2f/rjv00705.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/819d036ffaa6/rjv00701.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/02f940cf91fc/rjv00702.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/9a6730d4b1e9/rjv00703.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/b9fad919a994/rjv00704.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/7752e549ee2f/rjv00705.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/819d036ffaa6/rjv00701.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/02f940cf91fc/rjv00702.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/9a6730d4b1e9/rjv00703.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/b9fad919a994/rjv00704.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/4349996/7752e549ee2f/rjv00705.jpg

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本文引用的文献

1
Endovascular repair of aortic aneurysms: critical events and adjunctive procedures.主动脉瘤的血管内修复：关键事件及辅助操作
J Vasc Surg. 2001 Jun;33(6):1226-32. doi: 10.1067/mva.2001.115003.
2
The management of vascular injuries associated with total hip arthroplasty.全髋关节置换术相关血管损伤的处理
J Vasc Surg. 1990 Apr;11(4):549-55.
髋臼重建与关节置换术后双侧下肢缺血
BMJ Case Rep. 2018 May 18;2018:bcr-2017-223779. doi: 10.1136/bcr-2017-223779.