PDF(Pubmed)
Abstract：
UNASSIGNED: Surgical management of popliteal artery aneurysms has been described for half a century. Long term development of the excluded aneurysm sac in the popliteal segment however remains widely unknown, with only a few small series describing outcomes. Residual aneurysm perfusion has the potential to lead to serious complications.
UNASSIGNED: A 63 year old man presents with skin and soft tissue necrosis of the right calf two years after proximal and distal aneurysm ligation and great saphenous vein bypass for a popliteal artery aneurysm. Computed tomography and magnetic resonance angiography show perfusion of the excluded aneurysm as well as extensive necrosis of the gastrocnemius muscle. Direct angiography of the aneurysm demonstrated retrograde aneurysm perfusion due to insufficient distal ligation with recurrent micro-embolisation to the calf via geniculate arteries. Coiling of the geniculate arteries was performed, plugging the connection to the tibiofibular trunk and embolisation of the aneurysm sac. After the intervention, no flow was seen in the aneurysm sac and the patient made full recovery.
UNASSIGNED: Residual aneurysm sac perfusion can lead to complications long after successful aneurysm exclusion. Follow-up after surgery of popliteal aneurysms should include observation of the excluded aneurysm sac with control of residual blood flow. For persistent sac perfusion, aneurysm enlargement or symptoms, further treatment should be considered. Surgical aspects such as complete transection of the artery after aneurysm ligation or end to end anastomosis of the bypass may be considered, to prevent such complications.
UNASSIGNED: A 63 year old man presents with skin and soft tissue necrosis of the right calf two years after proximal and distal aneurysm ligation and great saphenous vein bypass for a popliteal artery aneurysm. Computed tomography and magnetic resonance angiography show perfusion of the excluded aneurysm as well as extensive necrosis of the gastrocnemius muscle. Direct angiography of the aneurysm demonstrated retrograde aneurysm perfusion due to insufficient distal ligation with recurrent micro-embolisation to the calf via geniculate arteries. Coiling of the geniculate arteries was performed, plugging the connection to the tibiofibular trunk and embolisation of the aneurysm sac. After the intervention, no flow was seen in the aneurysm sac and the patient made full recovery.
UNASSIGNED: Residual aneurysm sac perfusion can lead to complications long after successful aneurysm exclusion. Follow-up after surgery of popliteal aneurysms should include observation of the excluded aneurysm sac with control of residual blood flow. For persistent sac perfusion, aneurysm enlargement or symptoms, further treatment should be considered. Surgical aspects such as complete transection of the artery after aneurysm ligation or end to end anastomosis of the bypass may be considered, to prevent such complications.
摘要：
■pop动脉动脉瘤的外科治疗已经描述了半个世纪。但是，在the段中排除的动脉瘤囊的长期发展仍然是未知的。只有几个小系列描述结果。残余动脉瘤灌注有可能导致严重的并发症。
■一名63岁的男子在近端和远端动脉瘤结扎和大隐静脉搭桥术后两年出现右小腿皮肤和软组织坏死。计算机断层扫描和磁共振血管造影显示排除的动脉瘤的灌注以及腓肠肌的广泛坏死。动脉瘤的直接血管造影术显示，由于远端结扎不足，并通过膝状动脉反复微栓塞至小腿，因此逆行动脉瘤灌注。对膝状动脉进行了盘绕，堵塞与胫腓干的连接并栓塞动脉瘤囊。干预之后,动脉瘤囊内未见血流,患者完全康复.
■动脉瘤囊的残余灌注可在成功排除动脉瘤后很长时间内导致并发症。pop动脉瘤手术后的随访应包括观察排除的动脉瘤囊并控制残余血流。对于持续的囊灌注，动脉瘤增大或症状，应考虑进一步治疗。可以考虑手术方面，例如动脉瘤结扎后动脉的完全横切或旁路的端到端吻合，防止这种并发症。
■一名63岁的男子在近端和远端动脉瘤结扎和大隐静脉搭桥术后两年出现右小腿皮肤和软组织坏死。计算机断层扫描和磁共振血管造影显示排除的动脉瘤的灌注以及腓肠肌的广泛坏死。动脉瘤的直接血管造影术显示，由于远端结扎不足，并通过膝状动脉反复微栓塞至小腿，因此逆行动脉瘤灌注。对膝状动脉进行了盘绕，堵塞与胫腓干的连接并栓塞动脉瘤囊。干预之后,动脉瘤囊内未见血流,患者完全康复.
■动脉瘤囊的残余灌注可在成功排除动脉瘤后很长时间内导致并发症。pop动脉瘤手术后的随访应包括观察排除的动脉瘤囊并控制残余血流。对于持续的囊灌注，动脉瘤增大或症状，应考虑进一步治疗。可以考虑手术方面，例如动脉瘤结扎后动脉的完全横切或旁路的端到端吻合，防止这种并发症。
