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动脉粥样硬化性腘动脉瘤,尤其涉及对侧。

Atherosclerotic popliteal aneurysms with particular regard to the contralateral side.

作者信息

Englund R, Schache D, Magee H R

机构信息

Department of Vascular Surgery, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia.

出版信息

Aust N Z J Surg. 1987 Jun;57(6):387-90. doi: 10.1111/j.1445-2197.1987.tb01381.x.

Abstract

A retrospective analysis of 75 patients with 103 atherosclerotic popliteal aneurysms, seen at Princess Alexandra Hospital, Brisbane, was undertaken to assess the results of management and the most appropriate approach to the contralateral popliteal aneurysm. These patients were seen between January 1968 and December 1985. There were no females, the mean age was 66.3 years and 36% of the patients had bilateral popliteal aneurysms. There was a high incidence of other associated aneurysms, abdominal aortic (21), femoral (12) and isolated iliac (3). Thrombosis in a popliteal aneurysm was the most common reason for presentation initially (48%), followed by detection of a lump in the popliteal fossa (22.6%), embolic phenomena (10.6%) and ruptured popliteal aneurysm (four cases). The most common presentation for contralateral aneurysms was detection of a lump in the popliteal fossa. Management of the contralateral popliteal aneurysm was classified as early, elective repair (n = 14) and no surgery or surgery delayed until the development of symptoms (n = 14). Outcome was classified as successful, retained and fully functional limb at follow-up; or failure, amputation or debilitating ischaemia. There was one failure among those undergoing early elective repair and seven failures among those undergoing no or delayed surgery (P = 0.033, Fisher's Exact Test). There were 79 reconstructions. Bypass and ligation (n = 54) resulted in two amputations and two long-term occlusions, interposition augmented vein graft (n = 15) in two amputations and no long-term occlusions and interposition Dacron grafts (n = 10) with no amputations and three long-term occlusions.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对布里斯班亚历山德拉公主医院收治的75例患有103个动脉粥样硬化性腘动脉瘤的患者进行了回顾性分析,以评估治疗结果以及处理对侧腘动脉瘤的最合适方法。这些患者于1968年1月至1985年12月期间就诊。患者均为男性,平均年龄66.3岁,36%的患者患有双侧腘动脉瘤。其他相关动脉瘤的发生率较高,腹主动脉瘤(21例)、股动脉瘤(12例)和孤立性髂动脉瘤(3例)。腘动脉瘤内血栓形成是最初就诊的最常见原因(48%),其次是腘窝处肿块的发现(22.6%)、栓塞现象(10.6%)和腘动脉瘤破裂(4例)。对侧动脉瘤最常见的表现是腘窝处肿块的发现。对侧腘动脉瘤的治疗分为早期选择性修复(n = 14)以及不手术或手术推迟至出现症状(n = 14)。结局分为成功,随访时肢体保留且功能完全正常;或失败,截肢或严重缺血。早期选择性修复的患者中有1例失败,未手术或延迟手术的患者中有7例失败(P = 0.033,Fisher精确检验)。共进行了79次重建手术。旁路移植和结扎术(n = 54)导致2例截肢和2例长期闭塞,间置增强静脉移植术(n = 15)导致2例截肢且无长期闭塞,间置涤纶移植术(n = 10)无截肢情况但有3例长期闭塞。(摘要截选至250字)

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