Melliere D, Becquemin J P, Cervantes-Monteil F, Le Chevillier B, Berrahal D
Department of Vascular Surgery, University of Paris-Val-de-Marne, Creteil, France.
Cardiovasc Surg. 1996 Aug;4(4):480-2. doi: 10.1016/0967-2109(95)00080-1.
This study was undertaken to evaluate the operative problems and the fate of patients operated on for recurrent femoral anastomotic false aneurysms, following aortofemoral bypass. It was found that 58 of 66 anastomotic false aneurysms which developed after aortoiliac or aortofemoral reconstruction were located at the femoral level, six at the anastomosis of the graft to the aorta and two at the iliac artery anastomosis. Six recurrences developed after surgical repair of femoral anastomotic false aneurysms but there were none after repair of aortic or iliac anastomotic false aneurysms. Of the six recurrences one patient was treated by direct repair and the remaining five by interposition of a prosthetic graft. There were no ischaemic complications or recurrences in a mean of three years. Elective, repeated repair is therefore a successful method of treating anastomotic false aneurysms. Deep sutures should be inserted into the arterial wall, tension should be avoided by placing an interposition graft when necessary, using a careful aseptic technique. Patients should be told to avoid extreme extension and rapid flexion-extension of the hip joint for the rest of their life.
本研究旨在评估在主动脉股动脉旁路移植术后，因复发性股动脉吻合口假性动脉瘤而接受手术治疗的患者所面临的手术问题及预后情况。研究发现，在66例因主动脉髂动脉或主动脉股动脉重建术后出现的吻合口假性动脉瘤中，有58例位于股动脉水平，6例位于移植血管与主动脉的吻合口处，2例位于髂动脉吻合口处。在对股动脉吻合口假性动脉瘤进行手术修复后，出现了6例复发情况，但在对主动脉或髂动脉吻合口假性动脉瘤进行修复后未出现复发。在这6例复发患者中，1例患者接受了直接修复治疗，其余5例采用人工血管置换术。平均三年来未出现缺血性并发症或复发情况。因此，选择性重复修复是治疗吻合口假性动脉瘤的一种成功方法。应在动脉壁上插入深部缝线，必要时通过置入人工血管避免张力，采用严格的无菌技术。应告知患者终生避免髋关节过度伸展和快速屈伸。
