Alevizacos P, Hepp W
Universitätsklinikum Rudolf Virchow/Standort Charlottenburg.
Vasa. 1994;23(2):131-7.
Anastomotic aneurysms represent late complications of reconstructive surgery. They are preferably localized in the inguinal area. From 1975 to 1989 forty patients were operated for 50 infrainguinal anastomotic aneurysms (46 inguinal, 4 popliteal). They developed after a mean time interval of 60.6 months. In nine cases bilateral inguinal aneurysms occurred. Three of the inguinal aneurysms were infected. The inguinal aneurysms were usually treated by total excision followed by prosthetic graft interposition with distal anastomosis to the deep femoral artery. If the superficial femoral artery was patent, it was inserted into the interposed graft. The infected aneurysms were treated with aseptic extra-anatomic bypass procedures. Five patients died after the operation. In one case a transmetatarsal amputation had to be performed and in one case a relapsing aneurysm occurred after three years. In general surgical repair of anastomotic aneurysms following vascular reconstructions should be performed before complications occur. In the inguinal area this can be performed with low local and general risk and with good longterm results.
吻合口动脉瘤是重建手术的晚期并发症。它们最好发于腹股沟区。1975年至1989年,40例患者接受了50例股下吻合口动脉瘤手术(46例腹股沟区,4例腘窝区)。这些动脉瘤平均在60.6个月的时间间隔后出现。9例为双侧腹股沟动脉瘤。3例腹股沟动脉瘤发生感染。腹股沟动脉瘤通常采用完全切除,然后植入人工血管,并与股深动脉进行远端吻合。如果股浅动脉通畅,则将其插入植入的人工血管。感染性动脉瘤采用无菌解剖外旁路手术治疗。5例患者术后死亡。1例患者不得不进行经跖骨截肢,1例患者术后三年出现复发性动脉瘤。一般来说,血管重建术后吻合口动脉瘤的外科修复应在并发症出现之前进行。在腹股沟区,手术可在局部和全身风险较低的情况下进行,且长期效果良好。