背景:髂动脉瘤很少见,孤立的髂动脉瘤仅占所有动脉瘤疾病的2%。髂外动脉(EIA)动脉瘤极为罕见,确切原因未知.在这种情况下,我们报告了一个巨大的动脉瘤,没有任何危险因素,出现破裂,并通过开放修复治疗。
方法:一名85岁的男子因突发右下腹腹痛和模糊的右下肢疼痛而就诊于急诊科。经过全面的体检,腹盆腔CT扫描显示80mmEIA动脉瘤,包含血栓形成和活动性渗漏。患者使用主动脉和EIA之间的移植物进行了动脉瘤的开放修复。手术顺利。后来在ICU,患者经历了心脏骤停,不幸的是无法康复。
结论:在这种情况下,动脉瘤相对较大的患者出现腹痛和下肢不适。虽然血管内手术被推荐用于修复髂动脉瘤,开放修复术对于破裂的动脉瘤很常见。血管内修复的侵入性较小,但可能导致造影剂引起的肾功能障碍。开放修复可能会引起并发症,如性功能障碍,移植物感染,和盆腔缺血性疾病。
结论:EIA动脉瘤极为罕见。他们可能会出现破裂,使患者处于危急状态,就像在这种情况下。由于血流动力学不稳定,开放修复术被认为是修复动脉瘤的主要方法之一。
BACKGROUND: Iliac artery aneurysms are rare, with isolated iliac artery aneurysms responsible for only 2 % of all aneurysmal diseases. External iliac artery (EIA) aneurysms are extremely rare, and the exact cause is unknown. In this
case, we report a giant aneurysm without any risk factor presented with rupture and managed by open repair.
METHODS: An 85-year-old man presented to the emergency department with sudden onset right lower quadrant abdominal pain and vague right lower limb pain. After a complete physical examination, an abdominopelvic CT scan revealed an 80 mm EIA aneurysm containing thrombosis and active leakage. The patient underwent open repair of an aneurysm using a graft between the Aorta and EIA. The surgery was uneventful. Later in the ICU, the patient experienced a cardiac arrest and unfortunately could not recover from it.
CONCLUSIONS: In this
case, a patient with a relatively large aneurysm presented with abdominal pain and lower limb discomfort. Although endovascular surgery is recommended for the repair of iliac aneurysms, open repair is common for ruptured aneurysms. Endovascular repair is less invasive but may lead to contrast-induced renal dysfunction. Open repair may induce complications such as sexual dysfunctions, graft infection, and pelvic ischemic conditions.
CONCLUSIONS: EIA aneurysms are exceedingly rare. They may present with a Rupture that puts the patient in critical condition, such as in this
case. Due to the hemodynamic instability, open repair is considered one of the main approaches for repairing the aneurysm.