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全膝关节置换术后腘动脉闭塞及假性动脉瘤形成的完全血管内治疗

Totally Endovascular Management of Popliteal Artery Occlusion and Pseudoaneurysm Formation after Total Knee Replacement.

作者信息

Reynolds Anthony, Sandstrom Anna, Jha Pankaj K

机构信息

Vascular Surgery Department, Nambour General Hospital, Nambour, Queensland, Australia.

Vascular Surgery Department, Nambour General Hospital, Nambour, Queensland, Australia.

出版信息

Ann Vasc Surg. 2017 Jan;38:316.e13-316.e16. doi: 10.1016/j.avsg.2016.05.100. Epub 2016 Aug 12.

Abstract

Injuries to the popliteal artery during total knee arthroplasty (TKA) are rare. We present a case of a 72-year-old man with popliteal artery thrombosis and a pseudoaneurysm presenting immediately after TKA. First-line management of acute limb ischemia is currently transitioning from open surgery to endovascular strategies such as catheter-directed thrombolysis or mechanical thrombectomy. Due to the rarity of acute limb ischemia and pseudoaneurysms after TKA, endovascular management is only reported in a few case studies. This case is distinctive by having both popliteal artery thrombosis and a pseudoaneurysm which were successfully managed entirely endovascular using AngioJet thrombolysis and a flexible covered stent. This case contributes to the evidence supporting endovascular management of this rare complication of TKA.

摘要

全膝关节置换术(TKA)期间腘动脉损伤较为罕见。我们报告一例72岁男性患者,在TKA术后即刻出现腘动脉血栓形成和假性动脉瘤。急性肢体缺血的一线治疗目前正从开放手术转向血管内治疗策略,如导管定向溶栓或机械血栓切除术。由于TKA术后急性肢体缺血和假性动脉瘤较为罕见,血管内治疗仅在少数病例研究中有报道。该病例的独特之处在于同时存在腘动脉血栓形成和假性动脉瘤,通过使用AngioJet溶栓和可弯曲覆膜支架成功地完全采用血管内治疗。该病例为支持TKA这种罕见并发症的血管内治疗提供了证据。

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