Hunter G C, Leong S C, Yu G S, McIntyre K E, Bernhard V M
Department of Surgery, Veterans Administration Medical Center, Tucson, AZ 85723.
J Vasc Surg. 1989 Jul;10(1):93-9.
Although the growth and rupture of abdominal aortic aneurysms are commonly explained by Laplace's law, the final events that precede aneurysm rupture are not fully understood. Local excrescences within the wall of abdominal aortic aneurysms were observed in four of five patients studied with preoperative CT scanning, and were removed from six patients at the time of surgery. These protrusions were filled with thrombus, and on histologic examination marked attenuation of the aortic wall, focal loss of elastic fibers, and inflammatory cell infiltrates of lymphocytes, plasma cells, and occasional multinucleate giant cells were seen. The presence of these blebs and their microscopic characteristics suggest their potential as a mechanism for rupture and recognition of this deformity by use of abdominal CT scanning may indicate the necessity for prompt surgical intervention. Further careful clinicopathologic correlation is required to clearly establish these localized defects in the aneurysm wall as a cause for rupture.
虽然腹主动脉瘤的生长和破裂通常用拉普拉斯定律来解释，但动脉瘤破裂前的最终事件尚未完全明了。在接受术前CT扫描的5名患者中，有4名观察到腹主动脉瘤壁内有局部赘生物，6名患者在手术时将其切除。这些突出物充满血栓，组织学检查显示主动脉壁明显变薄、弹性纤维局灶性缺失，并有淋巴细胞、浆细胞以及偶尔的多核巨细胞的炎性细胞浸润。这些小泡的存在及其微观特征表明它们可能是破裂的一种机制，通过腹部CT扫描识别这种畸形可能提示需要及时进行手术干预。需要进一步仔细的临床病理相关性研究，以明确将动脉瘤壁中的这些局部缺陷确定为破裂原因。
