血流减少辅助凝血酶注射治疗复杂股部假性动脉瘤：病例系列及文献综述
Flow Reduction-Aided Thrombin Injection for Complex Femoral Pseudoaneurysms: Case Series and Review of the Literature.
作者信息
Menon Nandakumar, Drucker Charles B, Bhardwaj Abhishek, Kalsi Richa, Crawford Robert S, Sarkar Rajabrata, Toursavadkohi Shahab
机构信息
Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.
Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.
出版信息
Ann Vasc Surg. 2018 Jan;46:367.e1-367.e6. doi: 10.1016/j.avsg.2017.06.032. Epub 2017 Jun 21.
BACKGROUND
Peripheral pseudoaneurysms are a known complication of vascular access procedures. Complex lesions-those with short, wide necks or other complex arrangements-would conventionally require open repair, but we believe that even these lesions could be managed with an endovascular approach.
METHODS
Four patients with complex pseudoaneurysms were offered an open repair or thrombin injection with the use of flow-reducing balloons.
RESULTS
In our series of 4 patients with complex pseudoaneurysms, all were safely treated with percutaneous thrombin injection in conjunction with endovascular flow reduction. All patients recovered from their procedures without incident and are free from recurrence at follow-up.
CONCLUSIONS
Flow reduction-aided thrombin injection may have particular utility in complex femoral pseudoaneurysms, especially in a patient population that may not tolerate open repair. High-risk lesions may merit special consideration for this technique, and further study is warranted.
背景
外周假性动脉瘤是血管通路手术已知的并发症。复杂病变（即颈部短而宽或有其他复杂结构的病变）传统上需要开放修复，但我们认为即使是这些病变也可以采用血管内治疗方法。
方法
为4例患有复杂假性动脉瘤的患者提供开放修复或使用减流球囊注射凝血酶的治疗方案。
结果
在我们这组4例患有复杂假性动脉瘤的患者中，所有患者均通过经皮注射凝血酶并结合血管内减流术得到安全治疗。所有患者术后均顺利康复，随访期间无复发。
结论
减流辅助凝血酶注射在复杂股部假性动脉瘤中可能具有特殊作用，尤其是在无法耐受开放修复的患者群体中。高危病变可能值得对该技术进行特别考虑，有必要进一步研究。
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