Wang Tiehao, Zhao Jichun, Yuan Ding
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China.
Vascular. 2021 Apr;29(2):256-259. doi: 10.1177/1708538120950870. Epub 2020 Aug 24.
Ruptured popliteal artery aneurysm is a rare entity, which can cause severe nerve neuropathy. Open surgical repair is the preferred treatment for ruptured popliteal artery aneurysm but may aggravate nerve injuries or lead to postoperative aneurysm enlargement. The current surgical techniques for ruptured popliteal artery aneurysm have some deficiencies.
We present the case of a 78-year-old woman with sudden swelling of left knee joint and left foot drop, which was caused by the ruptured popliteal artery aneurysm and its compression. A modified open surgical repair was applied in our case, and glucocorticoid therapy was given perioperatively.
The motor function of left lower limb had rapidly recovered after operation, and six-month follow-up showed patency of prosthetic vessel and significant shrinkage of aneurysm sac.
Our modified open surgical repair can relieve the compression and prevent possible "type II endoleak" without dissecting in popliteal fossa. Acute common peroneal nerve neuropathy and foot drop are reversible with immediate removal of compression and glucocorticoid therapy for patients with ruptured popliteal artery aneurysm.
腘动脉动脉瘤破裂是一种罕见疾病，可导致严重的神经病变。开放手术修复是腘动脉动脉瘤破裂的首选治疗方法，但可能会加重神经损伤或导致术后动脉瘤扩大。目前治疗腘动脉动脉瘤破裂的手术技术存在一些不足之处。
我们报告了一例78岁女性患者，因腘动脉动脉瘤破裂及其压迫导致左膝关节突然肿胀和左足下垂。我们对该病例采用了改良的开放手术修复，并在围手术期给予糖皮质激素治疗。
术后左下肢运动功能迅速恢复，六个月随访显示人工血管通畅，动脉瘤囊显著缩小。
我们改良的开放手术修复可在不解剖腘窝的情况下解除压迫并预防可能的“II型内漏”。对于腘动脉动脉瘤破裂患者，立即解除压迫并给予糖皮质激素治疗，急性腓总神经病变和足下垂是可逆的。
