Pecoraro Felice, Dinoto Ettore, Bracale Umberto M, Badalamenti Giovanni, Farina Arduino, Bajardi Guido
Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone", Palermo, Italy.
Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone", Palermo, Italy.
Ann Vasc Surg. 2017 Jul;42:303.e5-303.e9. doi: 10.1016/j.avsg.2016.11.026. Epub 2017 Apr 5.
Deep femoral artery pseudoaneurysms (DFAPs) are rare and generally occur after penetrating trauma or surgical procedures. A 36-year-old obese man presented with pain in correspondence of the anterior-lateral thigh after 6 months from gunshot wound. Duplex and computed tomography (CT) showed a bilobed right DFAP (maximal diameter 12.9 cm). The patient was managed urgently, under local anesthesia, by placement in the distal DFA of a Viabahn 8 × 100-mm stent graft (W L Gore & Associates, Inc). The postoperative course was uneventful, and the 24-month CT showed regular stent-graft patency and 20-mm DFAP shrinkage. The literature review reported 8 cases of DFAPs; of these 6 were managed by endovascular mean (3 stent-graft implantations and 3 coil embolization). The remaining 2 cases were managed surgically (one of these after failed coil embolization). In conclusion, the use of covered stent graft was effective to treat a DFAP localized in the medium DFA. This tool allowed maintaining the native DFA patency and the preservation of its main branches.
股深动脉假性动脉瘤（DFAPs）较为罕见，通常发生于穿透性创伤或外科手术后。一名36岁肥胖男性在枪伤6个月后出现大腿前外侧相应部位疼痛。超声和计算机断层扫描（CT）显示右侧双叶DFAP（最大直径12.9厘米）。患者在局部麻醉下紧急接受治疗，在股深动脉远端植入一枚8×100毫米的Viabahn覆膜支架移植物（WL Gore & Associates公司）。术后过程顺利，24个月的CT显示覆膜支架移植物通畅，DFAP缩小至20毫米。文献回顾报道了8例DFAP；其中6例采用血管内治疗（3例植入覆膜支架移植物，3例进行弹簧圈栓塞）。其余2例采用手术治疗（其中1例在弹簧圈栓塞失败后进行手术）。总之，使用覆膜支架移植物治疗位于股深动脉中段的DFAP有效。该方法能够维持股深动脉的通畅并保留其主要分支。
