Liew K W, Leong B D K
Hospital Queen Elizabeth, General Surgery Department, Vascular Unit, Kota Kinabalu, Sabah, Malaysia.
Med J Malaysia. 2016 Oct;71(5):302-303.
Popliteal artery pseudoaneurysm is uncommon. They usually result from penetrating or blunt trauma, arterial reconstructive surgery, invasive diagnostic or surgical orthopedic procedures. They can cause arterial thrombosis and limb ischeamia. We report a 53 year old Chinese gentleman with popliteal artery pseudoaneurysm who presented with right lower limb numbness and paralysis in toes extension. He gave a history of acupuncture treatment around the popliteal fossa of the affected limb. Clinical examination revealed a pulsatile mass in the popliteal fossa. Computed tomography angiography showed a large, 5 cm, pseudoaneurysm arising from the popliteal artery. A diagnostic angiogram was performed and revealed that there is no run off from the popliteal artery and the tibial vessels were reconstructed from collaterals. Endovascular intervention was carried out with an Amplatzer Vascular Plug to embolise the pseudoaneurysm. The pseudoaneurysm was successfully excluded and post-op follow up revealed no more pulsatile mass and improving lower limb function. To the best of our knowledge this is first reported case of pseudoaneurysm of the popliteal artery secondary to acupuncture in Malaysia.
腘动脉假性动脉瘤并不常见。它们通常由穿透性或钝性创伤、动脉重建手术、侵入性诊断或骨科手术引起。它们可导致动脉血栓形成和肢体缺血。我们报告一名53岁的中国男性患有腘动脉假性动脉瘤，表现为右下肢麻木及足趾背伸无力。他有在患侧腘窝周围接受针灸治疗的病史。临床检查发现腘窝处有一搏动性肿块。计算机断层血管造影显示一个5厘米的大假性动脉瘤，起源于腘动脉。进行了诊断性血管造影，结果显示腘动脉无血流流出，胫血管由侧支循环重建。采用Amplatzer血管封堵器进行血管内介入治疗以栓塞假性动脉瘤。假性动脉瘤成功被封堵，术后随访显示搏动性肿块消失，下肢功能改善。据我们所知，这是马来西亚首例报道的因针灸导致腘动脉假性动脉瘤的病例。
