Lam Danielle, Jansen Shirley, Tibballs Jonathan, McLean-Tooke Andrew
Department of Clinical Immunology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
BMJ Case Rep. 2020 Feb 23;13(2):e233315. doi: 10.1136/bcr-2019-233315.
A 41-year-old male patient presented with isolated right lower limb swelling. An ultrasound scan showed right external iliac and femoral vein deep vein thrombosis due to extrinsic compression by an aneurysm of the right common iliac artery. Investigations including imaging and a tissue biopsy of right and left femoral arteries confirmed a rare clinical presentation of fibromuscular dysplasia involving iliac, coeliac, renal and pulmonary vessels. The common iliac artery aneurysm was successfully treated with endovascular repair. Six months later, he developed coronary artery involvement with spontaneous dissection of left anterior descending artery diagnosed on coronary angiogram which was managed conservatively. At 6-year follow-up, he remains clinically asymptomatic and continues with regular surveillance imaging. Iliac arterial fibromuscular dysplasia is uncommon and clinical presentation with a complication such as a deep vein thrombosis is atypical.
一名41岁男性患者出现右下肢孤立性肿胀。超声扫描显示右髂外静脉和股静脉深静脉血栓形成，原因是右髂总动脉动脉瘤的外在压迫。包括影像学检查和左右股动脉组织活检在内的各项检查证实了一种罕见的临床情况，即纤维肌发育异常累及髂血管、腹腔干血管、肾血管和肺血管。右髂总动脉动脉瘤通过血管内修复成功治疗。6个月后，他出现冠状动脉受累，冠状动脉造影诊断为左前降支动脉自发性夹层，采取保守治疗。在6年的随访中，他临床上仍无症状，并继续定期进行监测成像检查。髂动脉纤维肌发育异常并不常见，出现深静脉血栓形成等并发症的临床表现并不典型。
