di Marzo L, Strandness E L, Schultz R D, Feldhaus R J
Ann Surg. 1987 Aug;206(2):168-72. doi: 10.1097/00000658-198708000-00009.
An experience on the surgical treatment of anastomotic false aneurysms during the last 15 years was reviewed. Fifty-nine were femoral anastomoses complicated by false aneurysm appearance requiring surgical excision. They represented 2.9% of all femoral anastomoses performed, whereas they represented 3.3% when considering reconstruction in which the femoral artery was the distal anastomosis. Reconstructions with distal anastomosis performed on the femoral artery were primarily involved (58 of 59), whereas grafts with "take off" from the femoral artery were rarely affected (p less than 0.05). A higher incidence of false aneurysm formation was demonstrated in hypertensive patients (p less than 0.05) as well as those who previously had femoral thromboendarterectomy (p less than 0.01). Infection was considered a causative factor even if it developed before (6-14 months) false aneurysm appearance. When a false aneurysm was resected, the best hemodynamic reconstruction, to avoid recurrence, was considered a bypass with distal anastomosis performed end-to-end on the femoral artery (p less than 0.05). The surgical treatment of choice was false aneurysm resection and graft interposition. However, a reanastomosis in the presence of small false aneurysms, when technically possible, has been successfully performed. Both treatments allowed good long-term results.
回顾了过去15年中吻合口假性动脉瘤的外科治疗经验。59例为股动脉吻合口并发假性动脉瘤形成，需要手术切除。它们占所有股动脉吻合术的2.9%，而在以股动脉为远端吻合口的重建手术中占3.3%。主要涉及在股动脉上进行远端吻合的重建手术（59例中的58例），而从股动脉“分支”的移植物很少受到影响（p<0.05）。高血压患者（p<0.05）以及既往有股动脉血栓内膜切除术的患者（p<0.01）中假性动脉瘤形成的发生率更高。即使感染在假性动脉瘤出现之前（6 - 14个月）就已发生，也被认为是一个致病因素。当切除假性动脉瘤时，为避免复发，最佳的血流动力学重建方法被认为是在股动脉上进行端对端远端吻合的旁路手术（p<0.05）。首选的外科治疗方法是假性动脉瘤切除和移植物植入。然而，在技术可行的情况下，对于小的假性动脉瘤进行重新吻合也已成功实施。两种治疗方法都取得了良好的长期效果。
