Salimi Javad, Nikraftar Parham, Rashidi Fatemeh, Azimi Mohammadreza, Shokri Amir
Department of Vascular Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran.
Department of Vascular Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran.
Int J Surg Case Rep. 2024 Mar;116:109406. doi: 10.1016/j.ijscr.2024.109406. Epub 2024 Feb 24.
Although endovascular therapy is becoming more used for the treatment of splenic artery aneurysms (SAAs) instead of open surgery, there is limited information available on the emergent hybrid approach, selectively. We present our experience of hybrid therapy using an emergent endovascular balloon for inflow control and open resection.
A 34-year-old woman was brought to the emergency room after it was reported that she had a pseudoaneurysm in her splenic artery at a different medical facility. The patient was hemodynamically stable. Then we underwent a combination of endovascular and open procedures, using balloon proximal control and open aneurysm resection. She was discharged from hospital on the fifth postoperative day after the operation.
There is no agreement on how to treat SAA patients. Endovascular procedures such as endovascular intervention are also being used, minimizing the risks of surgery and shortening the patient's hospital stay, but complications remain. We propose to try SAA's emergency hybrid strategy operation with a good prognosis and fewer complications.
It seems that, compared to open surgery alone when endovascular procedures were impossible, elective hybrid procedures are more secure and efficient in stable patients and could make the operation easier without more dissection for proximal control of splenic artery.
尽管血管内治疗越来越多地用于治疗脾动脉瘤(SAA)而非开放手术,但关于选择性急诊杂交手术的可用信息有限。我们介绍了使用急诊血管内球囊进行血流控制和开放切除的杂交治疗经验。
一名34岁女性在另一家医疗机构被诊断为脾动脉假性动脉瘤后被送往急诊室。患者血流动力学稳定。然后我们采用血管内和开放手术相结合的方法,使用球囊近端控制和开放动脉瘤切除术。术后第五天患者出院。
对于如何治疗SAA患者尚无共识。诸如血管内介入等血管内手术也在使用,可将手术风险降至最低并缩短患者住院时间,但并发症仍然存在。我们建议尝试SAA的急诊杂交策略手术,其预后良好且并发症较少。
似乎与在无法进行血管内手术时单纯进行开放手术相比,择期杂交手术在病情稳定的患者中更安全、更有效,并且无需更多地解剖脾动脉近端控制就能使手术更容易。