Department of Vascular Surgery, University General Hospital of Patras, Patras, Greece.
Vascular Unit, Department of Surgery, General Hospital of Patras, Patras, Greece.
Pan Afr Med J. 2022 Jun 15;42:122. doi: 10.11604/pamj.2022.42.122.29735. eCollection 2022.
Aneurysms of the tibial arteries are rare, and they most commonly occur due to trauma of the lower extremities. Acquired arteriovenous fistulas of the tibial arteries are a recognized complication of trauma of the lower extremity and they are related to the mechanism of the injury. Although the natural history of stable arteriovenous fistula is relatively benign, the aneurysms of the tibial arteries should be repaired with autologous vein bypass grafts, if there is distal ischemia. Endovascular repair has been reported as an effective alternative treatment for traumatic tibial artery aneurysms. The case of a 60-year-old male with the rare combination of a tibial artery aneurysm and traumatic arteriovenous fistula of the left lower extremity is reported in view of its rarity and the modern holistic endovascular approach used for treatment. A covered stent graft in the anterior tibial artery was used for the treatment of both the aneurysm and the arteriovenous fistula. The patient was discharged under dual antiplatelet treatment for three months, continued by clopidogrel as monotherapy. At the six-month follow-up, the patient has restored palpable peripheral pulses and no sign of recurrence or complication was recognized. A total endovascular approach can be an effective treatment for these complicated traumatic aneurysms.
胫动脉动脉瘤很少见，它们最常因下肢外伤而发生。获得性胫动脉动静脉瘘是下肢外伤的公认并发症，与损伤机制有关。尽管稳定的动静脉瘘的自然病史相对良性，但如果存在远端缺血，应使用自体静脉旁路移植修复胫动脉动脉瘤。腔内修复已被报道为治疗外伤性胫动脉动脉瘤的有效替代治疗方法。本文报告了 1 例 60 岁男性罕见的左下肢胫动脉动脉瘤和外伤性动静脉瘘的病例，鉴于其罕见性和现代整体腔内治疗方法，采用了前胫动脉覆膜支架治疗该病例的动脉瘤和动静脉瘘。患者接受了 3 个月的双联抗血小板治疗，然后继续氯吡格雷单药治疗。在 6 个月的随访中，患者恢复了可触及的周围脉搏，未发现复发或并发症的迹象。完全的腔内治疗方法可以是这些复杂外伤性动脉瘤的有效治疗方法。
