PDF(Pubmed)
Abstract：
Brachial artery pseudoaneurysms are a rare entity, which can occur secondary to infectious, traumatic, or iatrogenic causes. We present a 78-year-old female with end-stage renal disease on hemodialysis via a right brachio-basilic arteriovenous fistula. She had previously undergone numerous fistulograms and endovascular interventions for right upper extremity swelling due to prolonged bleeding following dialysis. After a recent fistulogram she developed recurrent arm swelling. Duplex showed a large hematoma without any evidence of vascular flow. However, intraoperatively, she was noted to have a giant 20 × 35 cm pseudoaneurysm of the brachial artery. Therapeutic options include endovascular stenting, embolization, thrombin injection, ultrasound-guided compression, and surgery. We elected to perform resection of the large pseudoaneurysm and arteriovenous fistula ligation due to the large size. Given her end-stage renal disease status and lacking quality autogenous vein, we were able to perform a patch angioplasty repair of her brachial artery without requiring a bypass.
摘要：
肱动脉假性动脉瘤是一种罕见的实体，可以继发于传染性疾病，创伤性,或医源性原因。我们介绍了一名78岁的女性，患有终末期肾病，通过右臂-贵重动静脉瘘进行血液透析。由于透析后出血时间延长，她以前曾接受过多次造瘘和血管内介入治疗右上肢肿胀。在最近的纤维造影后，她出现了反复的手臂肿胀。Duplex显示大量血肿，没有任何血管流动的证据。然而,术中,她被发现有一个巨大的20×35厘米的肱动脉假性动脉瘤。治疗方案包括血管内支架置入术,栓塞,凝血酶注射液,超声引导的压缩，和手术。由于体积较大，我们选择切除大型假性动脉瘤和动静脉瘘结扎术。鉴于她的终末期肾病状态和缺乏优质的自体静脉，我们能够在不需要搭桥的情况下对她的肱动脉进行补片血管成形术修复。
