评估先天性巨大股动脉假性动脉瘤的手术治疗策略

RA Yaqoob, MA Mustafa, GM Zafar, Maa Javaid, UB Butt
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摘要

先天性巨大股动脉假性动脉瘤给临床带来了巨大挑战,需要及时干预以预防并发症。尽管血管内技术不断进步,但最佳手术策略仍不明确。本研究旨在评估手术治疗这些假性动脉瘤的技术和临床效果。目的评估手术修复先天性巨大股动脉假性动脉瘤的技术成功率和临床疗效。方法:进行回顾性队列研究:这项回顾性队列研究于 2022 年 7 月至 2023 年 7 月在巴基斯坦拉合尔的一家三级医院进行。共有 60 名确诊为先天性巨大股动脉假性动脉瘤的患者接受了手术修复。使用双相超声波和 CT 血管造影术对患者进行了 1 个月、3 个月和 6 个月的随访。数据分析旨在评估手术技巧、技术成功率和术后效果。统计分析采用描述性统计和卡方检验。结果所有患者(60 人)均成功接受了不同技术的手术修复:初次修复(30 人)、静脉补片血管成形术修复(15 人)、插植反向大隐静脉移植物(10 人)和插植合成达克龙移植物(5 人)。100%的病例都获得了技术成功,没有肢体缺失或术中、术后死亡病例。所有患者的症状都得到了缓解,其中一例术后腹股沟伤口感染患者通过抗生素和清创得到了有效控制。结论股动脉假性动脉瘤的开放性手术修补显示出良好的技术可行性,是治疗先天性巨大股动脉假性动脉瘤相关并发症的一线疗法。这些研究结果支持将手术干预作为处理这些棘手病例的实用方法。
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ASSESSMENT OF SURGICAL TREATMENT STRATEGIES OF IATROGENIC GIANT FEMORAL ARTERY PSEUDOANEURYSMS
Iatrogenic giant femoral artery pseudoaneurysms pose significant clinical challenges, necessitating prompt intervention to prevent complications. Despite advancements in endovascular techniques, optimal surgical strategies remain unclear. This study aimed to evaluate surgical treatment's technical and clinical outcomes for these pseudoaneurysms. Objective: To assess the technical success and clinical outcomes following surgical repair of iatrogenic giant femoral artery pseudoaneurysms. Methods: This retrospective cohort study was conducted at a tertiary care hospital in Lahore, Pakistan between July 2022 and July 2023. A total of 60 patients diagnosed with iatrogenic giant femoral artery pseudoaneurysms underwent surgical repair. It was followed up for one, three, and six months using Duplex ultrasound and CT angiography. Data were analyzed to evaluate surgical techniques, technical success rates, and postoperative outcomes. Statistical analysis was performed using descriptive statistics and chi-square tests. Results: All patients (n=60) underwent successful surgical repair with various techniques: primary repair (n=30), repair with vein patch angioplasty (n=15), interposition reversed saphenous vein graft (n=10), and interposition synthetic Dacron graft (n=5). Technical success was achieved in 100% of cases, with no limb loss or intraoperative/postoperative mortality. The presenting symptoms were resolved in all patients, with one case of postoperative groin wound infection being effectively managed with antibiotics and debridement. Conclusion: Open surgical repair of femoral pseudoaneurysms demonstrates excellent technical feasibility and serves as a first-line treatment for iatrogenic giant femoral artery pseudoaneurysm-associated complications. These findings support surgical intervention as a practical approach to managing these challenging cases.
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