复杂股动脉瘤的开放手术治疗(附4例报告)

Surgical treatment of complex femoral artery aneurysm:a clinical report of 4 cases

目的总结复杂股动脉瘤开放手术治疗的经验。方法4例复杂股动脉瘤患者共5侧复杂动脉动脉瘤,均行开放手术。观察分析不同病情的复杂股动脉瘤所适用的手术方式,及不同术式的治疗效果。结果4例患者中3侧患肢行动脉瘤切除术、2侧患肢行动脉瘤旷置术。术中5侧患肢均重建股深动脉,其中采用人工血管进行动脉重建4侧、自体大隐静脉进行动脉重建1侧。术后随访4~30个月,3例下肢疼痛患者症状均缓解,桥血管、股浅动脉、股深动脉均通畅。结论采用开放手术治疗复杂股动脉瘤效果较好,动脉瘤较局限时进行动脉瘤切除术,动脉瘤累及范围较大或病变段动脉难以解剖时可选择动脉瘤旷置术,术中需重建股深动脉。

Objective To summarize the experience of surgical treatment of complex femoral artery aneurysm.Methods Five complex femoral artery aneurysms of 4 patients who underwent surgical treatment were selected.The suitable surgical methods for complex femoral aneurysms with different conditions were analyzed,and the therapeutic effect was observed.Results Among the 4 patients,aneurysm resection was performed on 3 limbs and aneurysm exclusion was performed on 2 limbs.The deep femoral arteries were all reconstructed.Also,artificial vessels were used for arterial reconstruction in 4 limbs and autologous great saphenous vein was used in 1 limb.During the follow-up of 4-30 months,the artificial vessels,superficial femoral arteries and deep femoral arteries were all patent,and the pain of lower limbs was relieved in 3 cases.Conclusions Surgical treatment is effective for complex femoral artery aneurysm.Aneurysm resection can be performed when the aneurysm is relatively limited.However,when the aneurysm involves a large area or the artery is difficult to dissect,aneurysm exclusion can be selected.Revascularization of the deep femoral arteries is needed.