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伴有同步真性动脉瘤的动脉扩张;一名70岁男性股总动脉和股深动脉瘤的治疗——病例报告

Arteriomegaly with synchronous true aneurysms; Management of Common Femoral Artery and Profunda Femoris Artery aneurysms in a 70-year-old male - A case report.

作者信息

Yahya Okab, Obaisy Mohammad Mohannad, Al Laham Omar, Ghannam Mohammad, Mohammad Ammar

机构信息

Department of Surgery, Al-Mouwasat University Hospital, Mazzah, Damascus, Syria; Department of Surgery, Al Assad University Hospital, April 17th St. Kafar Sousah, Damascus, Syria.

Department of Vascular Surgery, Al Assad University Hospital, April 17th St. Kafar Sousah, Damascus, Syria..

出版信息

Int J Surg Case Rep. 2022 May;94:107161. doi: 10.1016/j.ijscr.2022.107161. Epub 2022 May 4.

Abstract

INTRODUCTION AND IMPORTANCE

Arteriomegaly is characterized by an abnormal elastic defect of arterial vessels, which causes them to become elongated and tortuous. This raises the risk of limb loss due to thromboembolism, bleeding, infection, aneurysmal degeneration, dissection, or rupture. Despite asymptomatic presentations, surgical intervention could be warranted to plummet the morbidity and mortality associated with this pathology.

CASE PRESENTATION

We report the case of a 70-year-old male who presented with intermittent claudication in the left lower limb at a 100 m. Clinical examination revealed a pulsatile mass in the left groin with absent pulses in the left Popliteal and Pedal arteries. Radiology demonstrated a diffuse enlargement of the Abdominal Aorta with an infrarenal AAA, a L-CFA aneurysm, and a L-PFA aneurysm accompanied by occlusion of the L-SFA. Open surgical repair was achieved.

CLINICAL DISCUSSION

Our patient was managed by arterial ligation and surgical excision of both concomitant aneurysms where we placed a Dacron graft from the L-CIA to the branch of the L-PFA whilst placing a supported ePTFE graft from the previously mentioned Dacron graft of the deep femoral branch to the left below-knee Popliteal Artery.

CONCLUSION

Arteriomegaly is considered an exceptionally rare and progressive disease. Patients affected by this pathology have higher incidence rates of aneurysmal degeneration and even loss of the affected limb, especially if it's a peripheral aneurysm. Bypass surgical repair is feasible with positive outcomes, and it is prophylactic against the wide spectrum of dire consequences for patients.

摘要

引言与重要性

动脉扩张症的特征是动脉血管存在异常弹性缺陷,导致血管变长且扭曲。这增加了因血栓栓塞、出血、感染、动脉瘤退变、夹层形成或破裂而导致肢体丧失的风险。尽管有无症状表现,但可能仍需进行手术干预以降低与此病理相关的发病率和死亡率。

病例介绍

我们报告一例70岁男性患者,该患者在行走100米时出现左下肢间歇性跛行。临床检查发现左腹股沟有搏动性肿块,左侧腘动脉和足背动脉搏动消失。影像学检查显示腹主动脉弥漫性扩张,伴有肾下腹主动脉瘤、左股总动脉瘤和左股浅动脉瘤,同时左股浅动脉闭塞。实施了开放手术修复。

临床讨论

我们的患者接受了动脉结扎和两个伴发动脉瘤的手术切除,在此过程中,我们从左髂总动脉放置了一个涤纶移植物至左股浅动脉分支处,同时从上述股深动脉分支的涤纶移植物至左膝下腘动脉放置了一个支撑性聚四氟乙烯移植物。

结论

动脉扩张症被认为是一种极其罕见且进行性的疾病。受此病理影响的患者动脉瘤退变发生率较高,甚至受影响肢体丧失的发生率也较高,尤其是外周动脉瘤。旁路手术修复是可行的,且效果良好,对患者预防一系列严重后果具有积极意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9014/9092966/f205b6d4aab4/gr1.jpg

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