年轻人下肢缺血的一个非常罕见的原因:腘动脉夹闭。

The Open Cardiovascular Medicine Journal Pub Date : 2018-03-30 eCollection Date: 2018-01-01 DOI:10.2174/1874192401812010018
Hasan Baki Altinsoy, Ozkan Alatas, Emjed Khalil, Kenan Abdurrahman Kara, Candan Cudi Okten, Omer Faruk Dogan
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引用次数: 7

摘要

背景:腘动脉夹持综合征(PAES)是一种非常罕见的病理,可导致健康年轻人下肢缺血。腘动脉(PA)与周围肌肉肌腱结构之间的异常解剖关系导致PAES。我们介绍了31例35条肢体的PAES患者,这些患者在12年内在我们的诊所接受了手术治疗。患者与方法:2001 - 2015年,31例PAES患者(平均年龄32±7.4岁)接受手术治疗。;4例患者出现双侧PAES。多普勒超声(US)、磁共振血管造影(MRA)和常规血管造影作为诊断程序。1型PAES 4例,2型PAES 12例。在其余19个肢体中,我们诊断为III型或IV型PAES。简单释放PA, PA栓塞切除术和简单释放,桡动脉(RA)贴片血管成形术,伴或不伴血栓动脉内膜切除术(TEA)。在12个肢体中,通过RA介入提供PA连续性。结果:除5例患者外,术后未见并发症。血肿2例,局部感染2例。1例患者术后12小时因复发性PA血栓栓塞事件需要复查。中位随访23个月(范围:11-29个月),无术后并发症。结论:PAES可导致年轻健康患者慢性血管损伤所致的下肢缺血。使用诊断工具,如US,一种无创方法,MRA是早期诊断的有效诊断工具。通过他们的联合方法,可以实现准确和早期的诊断。当需要干预以防止疾病早期肢体丧失时,单独或联合RA动脉旁路治疗PA释放是一种可行的治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A Very Rare Cause of Lower Limb Ischemia in Young People: Popliteal Artery Entrapment.

A Very Rare Cause of Lower Limb Ischemia in Young People: Popliteal Artery Entrapment.

A Very Rare Cause of Lower Limb Ischemia in Young People: Popliteal Artery Entrapment.

A Very Rare Cause of Lower Limb Ischemia in Young People: Popliteal Artery Entrapment.

Background: Popliteal artery entrapment syndrome (PAES) is a very rare pathology that can cause lower extremity ischemia in healthy young people. Anomalous anatomic relationships between the popliteal artery (PA) and the surrounding musculo-tendinous structures cause PAES. We present 31 patients with PAES in 35 limbs that were treated surgically in our clinic within a 12-year period.

Patients and methods: From 2001 to 2015, 31 patients (mean age: 32 ± 7.4 years) underwent surgery for PAES. ; 4 patients presented had bilateral PAES. Doppler ultrasonography (US), magnetic resonance angiography (MRA), and conventional angiography were performed as diagnostic procedures. We detected Type I PAES in 4 limbs and Type II PAES in 12 limbs. In the remaining 19 limbs, we diagnosed Type III or Type IV PAES. Simple release of the PA, PA embolectomy and simple release, and the radial artery (RA) patch angioplasty, with or without thromboendarterectomy (TEA), were performed. In 12 limbs, PA continuity was provided by RA interposition.

Results: With the exception of 5 patients, no complications were seen after surgery. Haematoma was detected in 2 patients and local infection in 2 patients. One patient required a revision for recurrent PA thromboembolic event 12 h after surgery. At a median follow- up of 23 months (range: 11-29 months), there were no postoperative complications.

Conclusions: PAES can result in lower limb ischemia due to chronic vascular trauma in young healthy patients. The use of diagnostic tools such as US, a non-invasive method, and MRA are effective diagnostic tools for early diagnosis. With their combined approach, exact and early diagnosis can be achieved. PA release, alone or with arterial bypass using RA, is a viable treatment option when intervention is necessary to prevent limb loss in the early stages of the disease.

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