Dennis J W, Littooy F N, Greisler H P, Baker W H
Arch Surg. 1986 Mar;121(3):314-7. doi: 10.1001/archsurg.1986.01400030068012.
Anastomotic pseudoaneurysms continue to be a late complication of vascular grafting procedures. We reviewed the records of 48 patients who presented with 65 abdominal or lower extremity anastomotic pseudoaneurysms during 1977 to 1985. The interval between the original operation and the development of a pseudoaneurysm was 6.2 years (range, 2.5 months to 19 years). Most patients underwent resection of the involved segment of graft and artery with placement of an interposition graft. Graft patency was 97.5% during a mean follow-up of 2.4 years (range, two months to five years), and one operative mortality occurred. Four patients had emergency procedures; one patient underwent reconstruction, and three others underwent resection of the pseudoaneurysms alone. Two of those patients died, and the one survivor eventually required a high amputation. We recommend aggressive diagnosis and surgical reconstruction in these patients usually by interposition grafts or anastomotic revisions because the short- and long-term results are excellent. Morbidity and mortality are greatly increased when these procedures are done emergently.
吻合口假性动脉瘤仍然是血管移植手术的一种晚期并发症。我们回顾了1977年至1985年间48例出现65处腹部或下肢吻合口假性动脉瘤患者的记录。初次手术与假性动脉瘤形成之间的间隔时间为6.2年（范围为2.5个月至19年）。大多数患者接受了受累移植物和动脉段的切除，并置入了间置移植物。在平均2.4年（范围为2个月至5年）的随访期间，移植物通畅率为97.5%，发生了1例手术死亡。4例患者接受了急诊手术；1例患者接受了重建手术，另外3例仅接受了假性动脉瘤切除术。其中2例患者死亡，1例幸存者最终需要高位截肢。我们建议对这些患者进行积极的诊断和手术重建，通常采用间置移植物或吻合口修复术，因为短期和长期效果都很好。当急诊进行这些手术时，发病率和死亡率会大大增加。
