■多年来,pop动脉动脉瘤(PA)的参考治疗包括通过近端和远端结扎进行手术排除,结合了pop肌,股pop或股胫旁路。排除这些动脉瘤,但留在原地,通常因血栓形成而缩小。然而,情况并非总是如此。我们报告了一名双侧PA患者。右侧动脉瘤完全切除,一个正常的后续行动。左边的通过结扎和搭桥排除,不切除,但继续灌注,并移植到皮肤上。由于通过膝关节动脉的逆行侧支循环,动脉瘤继续生长,对应于\"类型2内漏。“因此,我们对动脉瘤及其瘘路径进行了切除。发展是有利的,此后患者的动脉状况令人满意。这一极为罕见的病例促使我们回顾PAs的治疗方案,并探索动脉瘤的造流潜力。
■对动脉瘤瘘的临床表现进行了文献综述,他们的病理生理学,以及PA的手术和血管内治疗。
■各种研究证明了切除治疗的优越性,与单独的排斥治疗相比,效果更好,再干预更少。
■鉴于这种情况,正如文献搜索所证明的那样,我们认为手术切除PA是治疗它们的最佳方法,而不是单独的手术或血管内排除治疗。
UNASSIGNED: For many years, the reference treatment for popliteal artery aneurysms (PA) consists of surgical exclusion by proximal and distal ligation, combined with popliteopopliteal, femoropopliteal or femorotibial bypass. These aneurysms excluded, but left in situ, generally decrease in size by thrombosis. However, this is not always the
case. We report on a patient with bilateral PAs. The right aneurysm was completely resected, with a normal follow-up. The left one was excluded by ligation and bypass, without resection, but continued to be perfused, and fistulised to the skin. The aneurysm continued to grow due to retrograde collateral circulation through the knee\'s articular arteries, corresponding to a \"type 2 endoleak.\" We therefore performed resection of the aneurysm and its fistulous path. The evolution was favourable and the patient has a satisfactory arterial condition since then. This extremely rare
case prompted us to review PAs\' treatment options and explore the arterial aneurysms\' fistulising potential.
UNASSIGNED: A review of the literature was performed on the aneurysmal fistulas\' clinical manifestation, their pathophysiology, and the PAs\' surgical and endovascular treatment.
UNASSIGNED: Various studies demonstrated a superiority of resection treatments, with better results and fewer reinterventions than exclusion treatments alone.
UNASSIGNED: In view of this
case, and as demonstrated by a literature search, we consider the surgical resection of PAs to be the optimal method for their management, rather than the surgical or endovascular exclusion treatment alone.