Raptis S, Baker S R
Department of Vascular Surgery, Royal Adelaide Hospital, University of Adelaide, South Australia.
Eur J Vasc Endovasc Surg. 1996 Feb;11(2):148-52. doi: 10.1016/s1078-5884(96)80043-8.
To determine the incidence and management of infected false aneurysms following carotid endarterectomy.
Case notes of patients undergoing carotid endarterectomy (CEA) between the years of 1980 and 1993 at two major teaching hospitals, or those patients who represented with complications were reviewed.
Eight patients were identified with infected false aneurysms, an incidence of 0.625%, in five CEA had been performed at one of the teaching hospitals, whilst in three other cases the primary operation had been done elsewhere. Presentation was a median 19 days following CEA. In five cases the original arteriotomy was closed by direct suture whilst in three a saphenous vein patch was used. Staphylococcal organisms were cultured in all cases. Antibiotics had not been administered at the original operation. Repair with saphenous vein graft from the common to the internal carotid artery had the least complications.
Infected false aneurysms are a rare complication following CEA, resection of the false aneurysm and reconstruction with autologous saphenous vein is recommended. Ligation alone is associated with a high incidence of stroke.
确定颈动脉内膜切除术后感染性假性动脉瘤的发生率及处理方法。
回顾了1980年至1993年间在两家主要教学医院接受颈动脉内膜切除术（CEA）的患者的病历记录，或那些出现并发症的患者的病历记录。
确定了8例感染性假性动脉瘤患者，发生率为0.625%，其中5例CEA在其中一家教学医院进行，而其他3例的初次手术在其他地方进行。出现症状的时间中位数为CEA术后19天。5例患者通过直接缝合关闭了原来的动脉切开处，3例使用了大隐静脉补片。所有病例均培养出葡萄球菌。初次手术时未使用抗生素。用大隐静脉从颈总动脉至颈内动脉进行搭桥修复的并发症最少。
感染性假性动脉瘤是CEA术后一种罕见的并发症，建议切除假性动脉瘤并用自体大隐静脉进行重建。单纯结扎与中风的高发生率相关。
