Darwis Patrianef, Putri Redita Noviana, Elfizri Zatira
Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Int J Surg Case Rep. 2021 Dec;89:106618. doi: 10.1016/j.ijscr.2021.106618. Epub 2021 Nov 23.
Pseudoaneurysms of the fibular artery are rare. Recently, endovascular techniques have been preferred over open surgery.
A 50-year-old male patient complained of recurrent bleeding from surgical wounds that had been present for one month. The patient sustained an open cruris fracture. No source of active bleeding was found at the time of exploration. The patient has then performed angiography with coiling and showed a pseudoaneurysm originating from the left fibular artery branch. Surgical debridement and external fixation were performed one day after the angiography and embolization procedure. The patient was discharged on the third day, and there has been no recurrent bleeding ever since.
A pseudoaneurysm can be thought of as one of the intractable bleeding causes. Recently, the endovascular technique has been commonly used as an alternative treatment if we did not find the source of bleeding in exploration. Many kinds of the literature showed the success of using non-surgical management, especially the coil embolization as the patient received.
In the management of pseudoaneurysm following trauma which cannot be found in open surgery, an endovascular technique like coil embolization can be the alternative method.
腓动脉假性动脉瘤较为罕见。近年来,血管内技术相较于开放手术更受青睐。
一名50岁男性患者主诉手术伤口反复出血已持续一个月。该患者曾发生开放性小腿骨折。探查时未发现活动性出血源。随后患者接受了血管造影及弹簧圈栓塞术,显示有一个源自左腓动脉分支的假性动脉瘤。在血管造影和栓塞术后一天进行了手术清创及外固定。患者于第三天出院,此后未再出现反复出血情况。
假性动脉瘤可被视为难治性出血原因之一。近年来,如果在探查中未找到出血源,血管内技术通常被用作替代治疗方法。许多文献表明非手术治疗取得了成功,尤其是像该患者接受的弹簧圈栓塞术。
对于开放性手术中未发现的创伤后假性动脉瘤的处理,像弹簧圈栓塞这样的血管内技术可以作为替代方法。