Li Fei, Zhang Ruili, Chen Jiangping, Wang Xiang, Chu Haiwei, Zhao Wenjun
Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai, China.
Ann Transl Med. 2021 Feb;9(4):360. doi: 10.21037/atm-20-8189.
In this study we report on a patient with a left common iliac vein aneurysm; a condition rarely seen in vascular surgery. A 49-year-old man with no history of trauma or surgery underwent computed tomography (CT) for the evaluation of lumbago. A subsequent 64-slice CT angiogram revealed a left common iliac vein aneurysm. Surgery was performed due to the possibility of rupture. The aneurysm was successfully treated with clipping and sutures and a pre-discharge CT showed the aneurysm had shrunk. We combine our experience treating this patient with a review of the characteristics of other reported cases and methods used to treat iliac vein aneurysms. A definitive diagnosis is recommended in patients in whom an iliac vein aneurysm is suspected, with a CT angiogram being a dependable diagnostic method. There is still no unified standard for the treatment of aneurysms. Conservative treatment can be chosen for some small aneurysms in early stage, but close follow-up is needed. Surgical treatment is still recommended for some large aneurysms. Because we know that if an aneurysm ruptures, it can be life-threatening. If appropriate artificial blood vessels or coated stents are available, aneurysms resection combined with artificial blood vessel reconstruction or directly coated stents are good choices for aneurysms isolation. For some very large aneurysms, I personally think that lateral wall resection and suture of our aneurysms is also a method. Early follow-up results also proved that the method was effective. Surgery should be performed as early as possible. Our method of surgery may be used as a selective surgical method if the aneurysm is large or saccular in morphology.
在本研究中，我们报告了一例左髂总静脉动脉瘤患者；这种情况在血管外科中很少见。一名49岁男性，无外伤或手术史，因腰痛接受计算机断层扫描（CT）检查。随后的64层CT血管造影显示左髂总静脉动脉瘤。由于存在破裂风险，遂进行了手术。动脉瘤通过夹闭和缝合成功治疗，出院前的CT显示动脉瘤已缩小。我们结合治疗该患者的经验，回顾了其他已报道病例的特征以及用于治疗髂静脉动脉瘤的方法。对于疑似髂静脉动脉瘤的患者，建议进行明确诊断，CT血管造影是一种可靠的诊断方法。目前对于动脉瘤的治疗仍没有统一标准。对于一些早期的小动脉瘤可选择保守治疗，但需要密切随访。对于一些大动脉瘤仍建议进行手术治疗。因为我们知道，如果动脉瘤破裂，可能会危及生命。如果有合适的人工血管或覆膜支架，动脉瘤切除联合人工血管重建或直接置入覆膜支架是隔离动脉瘤的良好选择。对于一些非常大的动脉瘤，我个人认为动脉瘤侧壁切除并缝合也是一种方法。早期随访结果也证明该方法有效。手术应尽早进行。如果动脉瘤较大或形态为囊状，我们的手术方法可作为一种选择性手术方法。
