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创伤后胫前动脉假性动脉瘤:治疗挑战。

Post-traumatic pseudoaneurysm of the anterior tibial artery: therapeutic challenge.

作者信息

Belai Poliana Mazuchini, Assis Zaira Cristina Barbosa, Vieira Thiago Felipe de Moraes, Vieira Gislaine Dos Santos Rodrigues, de Almeida Henrique Alves, Lopes Thiago Vaz, da Silva João, Grillo Vinicius Tadeu Ramos da Silva

机构信息

Centro Universitário São Lucas - UNISL-Afya, Porto Velho, RO, Brasil.

Instituto Vascular e Endovascular de Rondônia, Porto Velho, RO, Brasil.

出版信息

J Vasc Bras. 2025 Mar 14;24:e20240120. doi: 10.1590/1677-5449.202401202. eCollection 2025.

Abstract

Subacute traumatic arterial pseudoaneurysms involving the infragenicular arteries are rarely discussed in the literature because they tend to be asymptomatic or manifest clinically subtle symptoms even at late stages. We describe the case of a 25-year-old patient with a perforation injury to the lower limb from a shard of glass, who, after two weeks, developed pain and swelling in the limb, which suggested deep vein thrombosis. Venous Doppler ultrasound ruled out thrombosis but revealed heterogeneous echogenicity in the anterior wall of the middle third of the anterior tibial artery with internal flow, suggesting a pseudoaneurysm. We opted for conventional surgical treatment and, after proximal and distal control of the artery, drainage of the local hematoma and primary suturing of the lesion were performed. Pseudoaneurysm of the infrapatellar arteries, although rare, is a challenging clinical entity that requires early diagnosis.

摘要

涉及膝下动脉的亚急性创伤性动脉假性动脉瘤在文献中很少被讨论,因为它们往往无症状,甚至在晚期临床表现也很轻微。我们描述了一名25岁患者的病例,该患者因玻璃碎片导致下肢穿孔伤,两周后出现肢体疼痛和肿胀,提示深静脉血栓形成。静脉多普勒超声排除了血栓形成,但显示胫前动脉中1/3前壁回声不均匀,内部有血流,提示假性动脉瘤。我们选择了传统手术治疗,在对动脉进行近端和远端控制后,进行了局部血肿引流和病变的一期缝合。髌下动脉假性动脉瘤虽然罕见,但却是一个具有挑战性的临床实体,需要早期诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d2e/11922325/4bb5e6a075d3/jvb-24-e20240120-g01-en.jpg

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