Tuchmann A, Wagner O
Langenbecks Arch Chir. 1984;362(2):89-95. doi: 10.1007/BF01254183.
29 operations were performed because of an anastomotic aneurysm in 25 patients. The incidence of false aneurysm was 0.7% (4079 reconstructive operations from 1964 to 1979). Arterial reconstructions previous to the formation of aneurysm were: aorto-femoral bifurcation graft 9, ileo-femoral bypass 9, femoro-popliteal reconstructions 11 (4 of them were Sparks' prostheses). 31% of the cases had complications (rupture, thrombosis) when operated, 73% were located in the groin. At the primary operation mostly Dacron had been used. In all instances non-absorbable synthetic suture material has been applied. If the interval between the first operation and the formation of the aneurysms is short infection is to be suspected. The diagnosis of aneurysms distal to the inguinal ligament is easy, aneurysms of the iliac region were found after complications (rupture, thrombosis) had occurred. The most frequent reconstructive procedure was graft interposition, but aneurysmorrhaphy was successful in certain cases. Two patients died postoperatively. Follow-up showed one recurrence (in the groin). We suggest that 1) insufficiency of the suture line because of tension 2) dilation of prosthetic dacron material have great importance for formation of anastomotic aneurysm, whereas local endarterectomy or end-side anastomosis do not seem to be significant.
25例患者因吻合口动脉瘤接受了29次手术。假性动脉瘤的发生率为0.7%（1964年至1979年共4079例重建手术）。动脉瘤形成前的动脉重建方式有：主动脉-股动脉分叉移植9例，髂-股动脉旁路移植9例，股-腘动脉重建11例（其中4例使用斯帕克斯假体）。31%的病例在手术时有并发症（破裂、血栓形成），73%位于腹股沟区。初次手术时大多使用涤纶。所有病例均应用了不可吸收的合成缝线材料。如果首次手术与动脉瘤形成之间的间隔时间短，则应怀疑有感染。腹股沟韧带远端动脉瘤的诊断容易，髂区动脉瘤是在并发症（破裂、血栓形成）发生后才被发现的。最常见的重建手术是移植血管置换，但在某些情况下动脉瘤缝扎术也取得了成功。两名患者术后死亡。随访发现1例复发（在腹股沟区）。我们认为：1）由于张力导致缝线处不足；2）涤纶人工血管材料扩张对吻合口动脉瘤的形成具有重要意义，而局部动脉内膜切除术或端侧吻合似乎并不重要。
