外周性假性动脉瘤的治疗：附29例报告

目的:探讨不同类型外周性假性动脉瘤(PSA)的有效治疗方式。方法:回顾性分析2011年3月—2015年12月收治的29例外周性PSA患者的临床资料。11例股动脉PSA中,9例采用瘤体清除、动脉结扎,2例行动脉转流术;4例肱动脉和2例桡动脉PSA采用瘤体清除、动脉修补;2例胫后动脉PSA、2例脾动脉PSA、3例髂内动脉PSA、1例肠系膜动脉PSA、2例颈外动脉PSA均采用弹簧圈栓塞;2例髂外动脉PSA采用覆膜支架治疗。结果:所有患者术后瘤腔完全闭塞,1例股动脉PSA术后出现肢体缺血、坏死,二期行截肢手术,1例感染性颈外动脉PSA术后死于咯血,其余患者疗效满意。结论:针对不同病因、不同部位的外周性PSA,选择适宜的治疗方式,有助于获得较好的疗效。

Treatment of peripheral arterial pseudoaneurysms: a report of 29 cases

Objective: To investigate the effective management for different types of peripheral arterial pseudoaneurysms (PSA). Methods: The clinical data of 29 patients with peripheral arterial PSA treated from March 2011 to December 2015 were analyzed retrospectively. Among 11 patients with femoral PSA, 9 cases underwent aneurysm resection and artery ligation and 2 cases were treated by arterial bypass. Four patients with brachial PSA and 2 patients with radial PSA underwent aneurysm resection and aneurysmorrhaphy, 10 patients, that included 2 cases with posterior tibial PSA, 2 cases with spleenic PSA, 3 cases with internal iliac PSA, one case with mesenteric PSA, and 2 cases with external carotid PSA, underwent coil embolization, and 2 patients with external iliac PSA underwent covered stent placement. Results: After operation, the lumen of PSA in all patients was completely occluded. One patient with femoral PSA developed limb ischemia and necrosis, and then was subjected to second stage amputation, and one patient with infectious external carotid PSA died of hemoptysis. Satisfactory results were achieved in all of the other patients. Conclusion: According to the causes and locations of peripheral arterial PSA, appropriate selection of treatment method may be important for satisfactory results.