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罕见病例:伴动静脉畸形的发育不良性腋动脉动脉瘤。

A Rare Case of Dysplastic Axillary Artery Aneurysm Associated with Arteriovenous Malformation.

机构信息

Unit of Vascular Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Unit of Vascular Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

出版信息

Ann Vasc Surg. 2021 Feb;71:536.e9-536.e14. doi: 10.1016/j.avsg.2020.09.053. Epub 2020 Nov 4.

Abstract

BACKGROUND

Axillary artery aneurysms are rare conditions, and their causes are various. They can determine severe complications, so the treatment is extremely important.

METHODS

We report the case of a young man affected by a saccular axillary artery aneurysm associated with intramuscular arteriovenous malformation, without symptoms except for the presence of a pulsatile mass. Duplex scan and computed tomography scan have been essential for a correct diagnosis and planning of the treatment. At first, the patient was submitted to coil embolization of an efferent vessel, and then he was treated surgically through ligation and detachment of the aneurysm and replacement of part of the axillary artery with a Dacron graft (Vascutek, Inchinnan, Renfrewshire, Scotland, UK).

RESULTS

Follow-up at 1 and 6 months revealed normal patency of the axillary arterty and the prosthetic graft with complete exclusion and thrombosis of the aneurysm sac.No sensitive nor motor deficit were observed.

CONCLUSIONS

Aneurysms of the axillary artery associated with intramuscular arteriovenous malformations are very rare, but have to be suspected. The treatment is challenging and can be surgical, endovascular, or hybrid, based on the patient's conditions and aneurysm's anatomical features.

摘要

背景

腋动脉动脉瘤是一种罕见的疾病,其病因多种多样。它们可能导致严重的并发症,因此治疗非常重要。

方法

我们报告了一例年轻男性患有囊状腋动脉动脉瘤,伴肌内动静脉畸形,除存在搏动性肿块外,无任何症状。双功能超声和计算机断层扫描对正确诊断和治疗方案的制定至关重要。首先,患者接受了流出道血管的线圈栓塞治疗,然后通过结扎和分离动脉瘤,并使用 Dacron 移植物(Vascutek, Inchinnan,Renfrewshire,Scotland,UK)置换部分腋动脉进行手术治疗。

结果

术后 1 个月和 6 个月的随访显示腋动脉和假体移植物通畅,动脉瘤囊完全闭塞和血栓形成。未观察到感觉和运动功能缺损。

结论

腋动脉动脉瘤伴肌内动静脉畸形非常罕见,但需要高度怀疑。治疗具有挑战性,可以根据患者的情况和动脉瘤的解剖特征选择手术、血管内或杂交治疗。

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