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血管腔内支架置入术与开放修复术治疗腋动脉瘤的手术管理:两例报告及文献综述

Surgical Management of Axillary Artery Aneurysms with Endovascular Stenting versus Open Repair: A Report of Two Cases and Literature Review.

作者信息

Tham Sher-Lyn, Guo Yuxin, Pang Maria Cui-Ying, Chng Jack Kian

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Department of Vascular Surgery, Singapore General Hospital, Singapore.

出版信息

Ann Vasc Surg. 2019 Jul;58:385.e11-385.e16. doi: 10.1016/j.avsg.2018.11.010. Epub 2019 Feb 11.

Abstract

BACKGROUND

Axillary artery aneurysms necessitate repair due to potential neurovascular complications. With increasing endovascular interventions for these uncommon lesions, there is a need to evaluate their usage against conventional open repair.

CASE

We discuss the management of 2 patients with symptomatic axillary artery aneurysms who presented to our institution. The first case is a 52-year-old lady with an enlarging left pulsatile mass, later found to be an axillary artery aneurysm, who underwent an open aneurysmal resection and interposition grafting. Meanwhile, endovascular stenting was performed for the second patient, a 65-year-old gentleman with a left axillary aneurysm.

DISCUSSION

While open repair remains the standard treatment of care for aneurysmal axillary arteries, endovascular interventions have gained popularity as a perceived less-invasive approach with possibly reduced morbidity risks.

CONCLUSIONS

Meticulous preoperative evaluation is required for patients with axillary artery aneurysms. Both methods of repair are viable options, and the most optimal surgical approach is dependent on a myriad of surgical and patient factors.

摘要

背景

由于潜在的神经血管并发症,腋动脉瘤需要进行修复。随着对这些罕见病变的血管内介入治疗不断增加,有必要将其与传统的开放修复进行疗效评估。

病例

我们讨论了两名因有症状的腋动脉瘤前来我院就诊患者的治疗情况。第一例是一位52岁女性,其左上肢搏动性肿物逐渐增大,后来发现是腋动脉瘤,她接受了开放性动脉瘤切除术和间置移植术。同时,为第二例患者,一位65岁患有左腋动脉瘤的男性,实施了血管内支架置入术。

讨论

虽然开放修复仍然是腋动脉瘤的标准治疗方法,但血管内介入治疗作为一种侵入性较小、可能降低发病风险且已得到广泛应用的方法。

结论

腋动脉瘤患者需要进行细致的术前评估。两种修复方法都是可行的选择,最佳的手术方式取决于众多手术和患者因素。

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