Sakata Tomoki, Mogi Kenji, Sakurai Manabu, Nomura Anan, Fujii Masahiko, Takahara Yoshiharu
Department of Cardiovascular Surgery, Heart and Vascular Institute, Funabashi Municipal Medical Center, Funabashi, Japan.
Department of Cardiovascular Surgery, Heart and Vascular Institute, Funabashi Municipal Medical Center, Funabashi, Japan.
Ann Vasc Surg. 2017 Aug;43:313.e5-313.e7. doi: 10.1016/j.avsg.2017.04.003. Epub 2017 May 4.
A 16-year-old boy developed pulsating pain and dysesthesia in his right knee. Computed tomography showed a large aneurysm in the right upper popliteal artery and a spiked bone tumor arising from the right distal femoral shaft. Pseudoaneurysm due to osteochondroma was suspected, and the patient underwent emergency surgery. A 2-mm pinhole was detected in the arterial wall behind the tumor. After resection of the tumor, the damaged arterial wall was removed, and the defect was repaired using a saphenous vein patch. We suggest that patch repair is preferable to direct closure or end-to-end anastomosis to prevent recurrent pseudoaneurysm at a later time, even if the defect is small.
一名16岁男孩右膝出现搏动性疼痛和感觉异常。计算机断层扫描显示右腘动脉上段有一个大动脉瘤,右股骨远端骨干有一个刺状骨肿瘤。怀疑是骨软骨瘤导致的假性动脉瘤,患者接受了急诊手术。在肿瘤后方的动脉壁上发现一个2毫米的针孔。切除肿瘤后,去除受损的动脉壁,用大隐静脉补片修复缺损。我们建议,即使缺损很小,为防止日后复发性假性动脉瘤,补片修复比直接缝合或端端吻合更可取。