■尺动脉(PUA)的假性动脉瘤可继发于多种病因,并可能导致疼痛,动脉供血不足,尺神经麻痹.鉴于PUA诊断的相对频率,关于其正确的诊断和管理策略尚无共识。这篇评论的目的是总结有关PUA的现有数据,并开发一种管理算法。
■根据PRISMA扩展范围审查指南进行了审查。包括手稿,如果他们1)研究18岁以上的患者,2)讨论PUA的细节和3)详细说明其管理。
■包括31份手稿,提供32例患者的数据,平均±标准差年龄为46.9±19.6岁。尺动脉损伤机制包括外伤(13/32,40.6%),医源性(9/32,28.1%),和固有的结缔组织病(4/32,12.5%),在其他人中。超声检查是最常见的成像方式(14/32,43.7%),大多数(22/32,68.8%)的患者接受了手术治疗,通常通过假性动脉瘤切除±静脉移植进行重建。非手术干预包括超声引导的压迫治疗和凝血酶注射。
■虽然PUA很少被诊断,诸如意外或医源性创伤之类的煽动事件继续被记录在案,缺乏管理指南。建议将双重超声检查作为一线成像研究,随后进行Allen测试以评估尺动脉与手灌注的混合优势。3厘米的假性动脉瘤被建议作为考虑干预的一般阈值,对引起疼痛或神经系统症状的较小病变的警告。这篇综述可供遇到PUA的医生参考。
UNASSIGNED: Pseudoaneurysm of the ulnar artery (PUA) can arise secondary to several inciting etiologies and may lead to pain, arterial insufficiency, and ulnar nerve palsy. Given the relative infrequency of PUA diagnosis, there is no consensus regarding its proper diagnosis and management strategies. The purpose of this review is to summarize the existing data regarding PUA and develop an algorithm for management.
UNASSIGNED: A review was performed following PRISMA Extension for Scoping Reviews guidelines. Manuscripts were included if they 1) studied patients over the age of 18, 2) discussed specifics of the PUA and 3) detailed its management.
UNASSIGNED: Thirty-one manuscripts were included, presenting data on 32 patients with a mean ± standard deviation age of 46.9 ± 19.6 years. Ulnar artery injury mechanism included trauma (13/32, 40.6 %), iatrogenic (9/32, 28.1 %), and inherent connective tissue disease (4/32, 12.5 %), among others. Ultrasonography was the most common imaging modality (14/32, 43.7 %), and a majority (22/32, 68.8 %) of patients were managed surgically, typically via
pseudoaneurysm resection ± venous grafting for reconstruction. Non-operative interventions included ultrasound-guided compression therapy and thrombin injection.
UNASSIGNED: While PUA are infrequently diagnosed, inciting events such as accidental or iatrogenic trauma continue to be documented, and management guidelines are lacking. Duplex ultrasonography is recommended as the first line imaging study, with subsequent Allen Test to assess for ulnar artery vs. mixed dominance for hand perfusion. A
pseudoaneurysm of 3 cm is proposed as a general threshold for considering intervention, with caveats for smaller lesions causing pain or neurologic symptoms. This review serves as a reference for physicians who encounter PUA.