17例腘动脉瘤外科治疗临床经验  

Open surgical repair of popliteal artery aneurysm in 17 patients

作　　者：高培显[1] 王默[1] 张精勇[1] 何玉祥[1] 王琼[1] 袁海[1] 徐磊[1] 董典宁[1] 张十一[1] 种振岳[1] 金星[1] 吴学君[1] 

机构地区：[1]山东大学附属省立医院血管外科,济南250021

出　　处：《中国血管外科杂志（电子版）》2016年第4期296-298,共3页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的总结腘动脉瘤外科治疗的临床经验。方法回顾性分析2005年5月至2015年12月期间17例腘动脉瘤患者的临床资料。结果 17例均行手术治疗,后侧入路行腘动脉瘤切除+自体静脉间置术10例,应用人工血管重建腘动脉1例;内侧入路行股腘动脉或股-胫后动脉自体大隐静脉旁路术5例,行腘动脉假性动脉瘤切除+自体大隐静脉补片成形术1例。平均随访时间为(4.5±3.3)年,1例术后2个月行截趾术;另1例因自体静脉桥血栓形成导致远端缺血坏死,术后6个月行膝上截肢术。因心脑血管疾病死亡3例,未发生动脉瘤相关的死亡。结论腘动脉瘤有症状者或瘤体直径大于2cm者应尽早手术,后侧入路行腘动脉瘤切除及自体静脉重建临床效果满意,应作为腘动脉瘤的首选治疗方案。Objective To evaluate open surgical repair for patients with popliteal artery aneurysm （PAA）. Methods Records of 17 patients with PAA from May 2005 to December 2015 were retrospectively analyzed in our institution. Results In the series, 17 PAA cases underwent operations, with aneurysmectomy and vein interpositon in 10 cases, aneurysmectomy and prosthetic graft interpositon in one case, aneurysm ligation and saphenous vein bypass grafting in 5 cases, and pseudoaneurysmectomy and saphenous vein patch plasty in one case. The mean follow-up period was （4.5±3.3） years. One patient underwent amputation of the toes 2 months after operation, and another patient received above-the-knee amputation for vein graft thrombosis and severe limb ischemia. There were 3 deaths from cardiovascular disease, and no aneurysm related death occurred. Conclusions PAA symptoms or size greater than 20 mm represent an absolute indication for repair. Venous arterial conduit and a posterior approach offer long -term advantages, and should be considered the treatment of choice.

关 键 词：腘动脉瘤 治疗 血管重建 

分 类 号：R654.3[医药卫生—外科学]