Erdoes L S, Brown W C
Section of Vascular Surgery, University of Arizona Health Sciences Center, Tucson 85724, USA.
Ann Vasc Surg. 1995 Jul;9(4):394-6. doi: 10.1007/BF02139413.
Ulnar artery aneurysms and pseudoaneurysms are rare lesions that usually occur distal to the wrist and cause symptoms as a result of embolization and not rupture. An elderly woman presented with acute rupture of an ulnar artery pseudoaneurysm proximal to the wrist, which caused severe neurologic compromise as a result of bleeding into Guyon's canal and the carpal tunnel. The patient had a remote wrist fracture resulting in a deformity that allowed the ulnar head to be in proximity to the ulnar artery. Rupture of the volar capsule with chronic abrasion of the artery eventually led to pseudoaneurysm formation and subsequent rupture. Emergency operative treatment with excision of the pseudoaneurysm, ulnar artery ligation, and repair of the volar capsule resulted in complete neurologic recovery without vascular compromise. This case is unique because of the proximal location of the pseudoaneurysm and the presentation with rupture. The anatomy, pathogenesis, and treatment options are discussed. Excision of the pseudoaneurysm with repair of the torn volar capsule is recommended to avoid recurrent problems. Vascular reconstruction is needed in cases where radial arterial flow is inadequate.
尺动脉动脉瘤和假性动脉瘤是罕见的病变，通常发生在腕部远端，其症状是由栓塞而非破裂引起的。一名老年女性出现腕部近端尺动脉假性动脉瘤急性破裂，由于血液渗入Guyon管和腕管，导致严重的神经功能损害。该患者有陈旧性腕部骨折，导致畸形，使尺骨头靠近尺动脉。掌侧关节囊破裂伴动脉慢性磨损最终导致假性动脉瘤形成并随后破裂。急诊手术治疗包括切除假性动脉瘤、结扎尺动脉和修复掌侧关节囊，结果神经功能完全恢复，且无血管并发症。该病例因其假性动脉瘤的近端位置和破裂表现而独特。文中讨论了解剖结构、发病机制和治疗选择。建议切除假性动脉瘤并修复撕裂的掌侧关节囊，以避免复发问题。在桡动脉血流不足的情况下，需要进行血管重建。
