A large idiopathic pseudoaneurysm of the popliteal artery: A case report

S. Budinski, D. Nikolić, J. Pasternak
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Abstract

Introduction. Pseudoaneurysm, also known as a false aneurysm, is a collection of blood which passes through individual layers of the blood vessel or through all layers, but it is retained in the surrounding soft tissues. Case Report. We report presents a 41-year-old patient with a large idiopathic pseudaneurysm of the second segment of the popliteal artery, referred by an orthopedist with a magnetic resonance image of the left leg. The patient's medical history showed that the pain started three weeks ago, the swelling in the left popliteal fossa about 6 months ago, and a large, painful, non-pulsatile tumefaction was found during the examination, resulting in a 90 degrees flexion contracture of the left knee. The magnetic resonance showed a pseudoaneurysm of the left popliteal artery, and an emergency computed tomography angiography was performed; it confirmed a pseudoaneurysm of the left leg second segment of the left popliteal artery without signs of obliterative diseases. The posterior approach and exposition of the popliteal artery was applied; autovenous graft interposition with a great saphenous vein of the right leg was done. Conclusion. Early diagnosis plays an important role in avoiding temporary and permanent complications. Arterial reconstruction with autovein grafting is a gold standard and a method of choice in the surgery of the pseudaneurysm of the popliteal artery. The temporary setting of occlusive Fogarty catheters reduces damage to the surrounding tissue, accelerates bleeding control, which together shortens the time of surgery.
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腘动脉大特发性假性动脉瘤1例
介绍。假性动脉瘤,也被称为假性动脉瘤,是一种血液的集合,它穿过血管的各个层或所有层,但它保留在周围的软组织中。病例报告。我们报告了一位41岁的患者,其腘动脉第二段有一个巨大的特发性假性动脉瘤,由骨科医生用左腿的磁共振图像转诊。患者病史显示,疼痛开始于三周前,约6个月前左腘窝肿胀,检查时发现大、痛、无搏动性肿胀,导致左膝90度屈曲挛缩。磁共振显示左腘动脉假性动脉瘤,并进行了紧急计算机断层血管造影;它证实了左腿左腘动脉第二段的假性动脉瘤,没有闭塞性疾病的迹象。应用后路显露腘动脉;采用自体静脉与右腿大隐静脉间置术。结论。早期诊断对于避免暂时性和永久性并发症起着重要作用。自体静脉移植动脉重建是腘动脉假性动脉瘤手术的金标准和首选方法。暂时设置阻塞的福格蒂导管减少了对周围组织的损伤,加速了出血的控制,这些共同缩短了手术时间。
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