Shlomin V V, Grebenkina N Iu, Bondarenko P B, Puzdriak P D, Dorofeev S Ia, Piaterichenko I A, Vereshchako G A
Department of Vascular Surgery, Municipal Multimodality Hospital No2, Saint Petersburg, Russia.
Angiol Sosud Khir. 2017;23(3):163-166.
Presented herein is a clinical case report concerning open surgical treatment of an arteriovenous fistula of the renal artery with a large venous aneurysm in the hilum of the right kidney and a giant cyst of the upper pole in a 28-year-old woman. The intraoperative findings revealed disunion of the arteriovenous fistula, followed by edge-to-edge suturing of the arterial defect. The venous aneurysm in the hilum of the right kidney was dissected and sutured by the edge-to-edge technique, with the additional varicose renal vein ligated. The postoperative period turned out to be uneventful with favourable convalescence and no complications. The check MSCT angiography performed 3 months later showed that the venous aneurysm was thrombosed, with no evidence of arterial blood ingress revealed. The excretory function of the kidney was preserved. Also discussed in the article are variants of diagnosis and treatment of an arteriovenous fistula of this localization and complications thereof.
本文介绍了一例28岁女性右肾动脉动静脉瘘伴肾门部大静脉瘤及上极巨大囊肿的开放手术治疗临床病例报告。术中发现动静脉瘘分离,随后对动脉缺损进行端端缝合。对右肾门部的静脉瘤进行解剖并采用端端技术缝合,同时结扎额外的肾静脉曲张。术后恢复顺利,无并发症。3个月后进行的MSCT血管造影检查显示静脉瘤已血栓形成,未发现动脉血进入的迹象。肾脏的排泄功能得以保留。文章还讨论了该部位动静脉瘘的诊断和治疗变体及其并发症。