Graver L M, Mulcare R J
J Cardiovasc Surg (Torino). 1986 May-Jun;27(3):294-7.
An unusual case of recurrent infected pseudoaneurysm seven years following carotid endarterectomy is described. The initial pseudoaneurysm was treated with resection and Dacron patch angioplasty. Recurrence one year later was caused by infection of the patch. Treatment with resection and autologous saphenous vein patch angioplasty resulted in cure. Pseudoaneurysm formation after carotid endarterectomy is unusual and can generally be traced to technical factors. Of the fifty reported cases, only seven (14%) resulted from or were associated with local infection. Avoidance of prosthetic patch material may help prevent this complication. If it does occur, management should include precise angiographic diagnosis, vascular control through previously unoperated areas, complete debridement of all necrotic and infected pseudocapsule, and, if necessary, reconstruction with autologous vein.
本文描述了一例颈动脉内膜切除术后七年复发性感染性假性动脉瘤的罕见病例。最初的假性动脉瘤采用切除及涤纶补片血管成形术治疗。一年后复发是由于补片感染所致。采用切除及自体大隐静脉补片血管成形术治疗后治愈。颈动脉内膜切除术后假性动脉瘤形成较为罕见，通常可追溯至技术因素。在已报道的50例病例中，仅有7例（14%）由局部感染引起或与局部感染相关。避免使用人工补片材料可能有助于预防这一并发症。如果发生这种情况，处理措施应包括精确的血管造影诊断、通过未手术区域进行血管控制、彻底清除所有坏死及感染的假包膜，必要时采用自体静脉进行重建。
