Morbidelli A, Caron R, Caldana G, Musazzi M, Capobianco M, Florianello F
II Divisione Chirurgia Generale Ospedale di Rho, Milano.
Minerva Chir. 1995 Nov;50(11):1013-8.
One case has been described of acute thrombosis of bilateral femoral anastomotic pseudoaneurysm. The clinical finding of bilateral acute ischemia of the lower limbs required urgent surgical treatment. The operative technique consisted of excision of anastomotic aneurysms and replacement by a new segment of prosthesis with an end-to-end anastomosis to the deep femoral artery. Pathogenesis of the pseudoaneurysms at the femoral anastomosis generally recognized numerous factors such as mechanical, graft or suture defects, hypertension, wound complications. Recognition of femoral anastomotic aneurysms is usually simple, when a pulsative mass is noted. In such a case (reported) of thrombosis of bilateral femoral pseudoaneurysms, preoperative diagnosis was more difficult. Anastomotic aneurysms of little size that occur later after original intervention require observation by echography and angiodinography. When rapid enlargement arises, urgent surgical treatment is required, before rupture or thrombosis. The surgical intervention consists of excision of the anastomotic aneurysm and replacement by a new segment of prosthesis between the prosthesis and the common or deep femoral artery. If the reconstruction at the level of femoral artery is not possible, the anastomosis is performed more distally, at the level of popliteal artery. The results are affected by the degree of urgency of surgery, with significant difference in favour of the patients Who underwent elective procedures.
曾有一例双侧股部吻合口假性动脉瘤急性血栓形成的病例报告。双下肢急性缺血的临床表现需要紧急手术治疗。手术技术包括切除吻合口动脉瘤，并用一段新的假体进行置换，与股深动脉进行端端吻合。股部吻合口假性动脉瘤的发病机制通常涉及多种因素，如机械因素、移植物或缝合缺陷、高血压、伤口并发症等。当发现搏动性肿块时，股部吻合口动脉瘤的诊断通常较为简单。在双侧股部假性动脉瘤血栓形成的此类病例（报告）中，术前诊断更为困难。初次干预后较晚出现的小尺寸吻合口动脉瘤需要通过超声检查和血管造影进行观察。当动脉瘤迅速增大时，在破裂或血栓形成之前需要进行紧急手术治疗。手术干预包括切除吻合口动脉瘤，并在假体与股总动脉或股深动脉之间用一段新的假体进行置换。如果无法在股动脉水平进行重建，则在更远处的腘动脉水平进行吻合。手术结果受手术紧急程度的影响，择期手术患者的结果有显著差异。
