Nakajima J, Ikegami T, Ishihara T, Murakami K, Morimoto K
Nihon Geka Gakkai Zasshi. 1986 Aug;87(8):921-5.
A 71-year-old man was operated for a complete occlusion of the left common iliac artery caused by arteriosclerosis obliterans. Cross-over bypass was performed from the right external iliac artery to the left superficial femoral artery in June 1978, using a Double Velour Dacron graft (Cooley) 8 mm in diameter. In February 1985, the patient noticed the pulsatile mass in his left groin. Angiography showed a false aneurysm at the distal anastomosis of the graft. On operation, 2 aneurysmal dilatations were found on the distal anastomosis. After resection of the aneurysms, the reconstruction was established by EPTFE graft successfully. The resected specimen showed that one of the aneurysms was caused by the anastomotic failure of the distal portion of the graft, but that the other was the false aneurysm caused by rupture of the implanted graft. Two ruptured holes were confirmed to be 20 X 25 mm, 10 X 15 mm in size respectively, 10 mm proximal to the anastomotic aneurysm. Rupture of the Dacron arterial prosthesis is a rare complication. Only 23 cases have been reported in the United States. But some literatures show that the incidence of the failure of the Dacron prosthesis was about 3%. Therefore, we should make a long-term follow-up to the patients implanted Dacron arterial prostheses.
一名71岁男性因动脉硬化闭塞症接受手术,治疗左髂总动脉完全闭塞。1978年6月,采用直径8mm的双绒面涤纶人工血管(库利),进行了从右髂外动脉到左股浅动脉的交叉搭桥术。1985年2月,患者注意到左腹股沟有搏动性肿块。血管造影显示人工血管远端吻合处有假性动脉瘤。手术中,在远端吻合处发现2处动脉瘤样扩张。切除动脉瘤后,成功采用膨体聚四氟乙烯人工血管进行了重建。切除的标本显示,其中一个动脉瘤是由人工血管远端部分的吻合失败引起的,但另一个是植入的人工血管破裂导致的假性动脉瘤。确认两个破裂孔的大小分别为20×25mm、10×15mm,位于吻合口动脉瘤近端10mm处。涤纶动脉假体破裂是一种罕见的并发症。在美国仅报道过23例。但一些文献表明,涤纶假体失败的发生率约为3%。因此,对于植入涤纶动脉假体的患者,我们应进行长期随访。