颈动脉内膜切除术后颈动脉假性动脉瘤的外科治疗
Surgical Treatment of Post-Carotid Endarterectomy Carotid Pseudoaneurysm.
作者信息
Lopes Alice, Gomes Miguel Lemos, Sobrinho Gonçalo, Pedro Luís Mendes
机构信息
Vascular Surgery Department-Heart and Vessels Division, Hospital de Santa Maria (CHLN), Lisbon, Portugal.
Lisbon Academic Medical Centre, Lisbon, Portugal.
出版信息
EJVES Short Rep. 2019 Jul 5;46:12-13. doi: 10.1016/j.ejvssr.2019.06.002. eCollection 2020.
Post-endarterectomy pseudoaneurysms (PEPA) are a rare complication of carotid endarterectomy (CEA), but are associated with high morbidity risk. Therefore, once they are diagnosed, treatment is urgent to prevent possible complications such as rupture, embolisation, thrombosis, or airway and cranial nerve compression. In this video, the surgical procedure is shown in a case of PEPA 10 years after CEA with patch angioplasty, which was successfully managed by surgical excision and interposition of great saphenous vein graft. Follow up duplex examination at six months was normal, with patency of the vein graft. This case reiterates the importance of open surgery as the treatment of choice for this difficult clinical setting.
动脉内膜切除术后假性动脉瘤（PEPA）是颈动脉内膜切除术（CEA）的一种罕见并发症，但与高发病风险相关。因此，一旦确诊，应紧急治疗以预防可能的并发症，如破裂、栓塞、血栓形成或气道及颅神经受压。在本视频中，展示了一例CEA并采用补片血管成形术10年后发生PEPA的手术过程，该病例通过手术切除并置入大隐静脉移植物成功治疗。术后6个月的双功超声复查结果正常，静脉移植物通畅。该病例再次强调了开放手术作为这种困难临床情况首选治疗方法的重要性。
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