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全膝关节置换术后八年诊断为腘动静脉瘘。采用Viabahn血管内假体进行血管内治疗及五年随访。

Popliteal Arteriovenous Fistula Diagnosed Eight Years after Total Knee Arthroplasty. Endovascular Treatment with Viabahn Endoprosthesis and Five-Year Follow-Up.

作者信息

Lozano-Sánchez Francisco Santiago, García-Alonso Jesús, Salvador-Calvo Roberto, Velasco-Pelayo Luis, García-Cenador María Begoña

机构信息

Angiology and Vascular Surgery Service, Salamanca University Hospital (CAUSA), 37008 Salamanca, Spain.

Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.

出版信息

Reports (MDPI). 2024 Jul 25;7(3):59. doi: 10.3390/reports7030059.

Abstract

BACKGROUND

Orthopedic surgery, while it rarely cause iatrogenic vascular lesions, leads to significant clinical, social, and economic consequences when it does. The knee is particularly susceptible to these injuries.

CASE DESCRIPTION

This case study presents the clinical case of a 71-year-old woman with a history of left total knee replacement. Eight years after the initial procedure, a popliteal-popliteal arteriovenous fistula was identified in the same knee. Given the location and caliber of the fistula, and despite the absence of symptoms, an endovascular prosthesis (Viabahn) was deployed in the popliteal artery to cover the fistula. The prosthesis remained intact for the remainder of the patient's life, who succumbed to metastatic cancer five years later. Additionally, a review of the literature was conducted.

CONCLUSION

This brief report describes an exceptional case of popliteal arteriovenous fistula, diagnosed eight years after a TKA, treated endovascularly and followed up over five years. Both pseudoaneurysms and arteriovenous fistulae should also be considered for early detection.

摘要

背景

骨科手术虽极少引发医源性血管损伤,但一旦发生,会导致严重的临床、社会和经济后果。膝关节尤其容易受到此类损伤。

病例描述

本病例研究呈现了一名71岁女性的临床病例,该患者有左全膝关节置换史。初次手术后八年,在同一膝关节处发现了腘动脉-腘静脉瘘。鉴于瘘管的位置和管径,尽管患者无症状,仍在腘动脉中植入了血管内假体(Viabahn)以覆盖瘘管。该假体在患者余生中保持完好,患者五年后因转移性癌症去世。此外,还进行了文献综述。

结论

本简短报告描述了一例罕见的腘动脉-腘静脉瘘病例,在全膝关节置换术后八年确诊,采用血管内治疗并随访五年。还应考虑对假性动脉瘤和动静脉瘘进行早期检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d700/12225331/9ca5392feb2b/reports-07-00059-g001.jpg

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