Analysis of clinical treatment of pseudoaneurysms in limbs

LIU Jian-yin; SHI Ming-guo; ZHANG You-le; SHEN Cheng

doi:10.3969/j.issn.2095-252X.2014.03.017

Abstract：Objective To retrospectively summarize the clinical features and follow-up effects of 28 cases of pseudoaneurysms in limbs. Methods The microsurgical technique was used in the treatment of 28 patients with pseudoaneurysms in limbs. Among them, 4 patients were treated with pseudoaneurysms resection and artery repair, 8 patients with pseudoaneurysms resection and end to end artery anastomosis and 16 patients with pseudoaneurysms resection and autogenic vein transplantation, including 10 patients with autotransplantation of great saphenous vein, 4 patients with cephalic vein graft and 2 patients with artiifcial blood vessel transplantation. Results The operation was successfully performed on all 28 patients. The wound healing by ifrst intention occurred in 2 of the 3 patients treated with free skin grafting. A patient with partial necrosis underwent skin grafting again and survived 2 weeks after the dressing. The mean follow-up period was 68 months ( range;1-10 years ). The clinical and ultrasound examinations showed the repaired artery was patent and no recurrence of pseudoaneurysms was found. Two years later, the ultrasound examination revealed mild venous dilatation in 10 of the patients with autogenic vein transplantation, but no aneurysms were noticed. At 6 months after the pseudoaneurysms resection and repair operation, the symptom disappeared in 6 patients with adjacent nerve compression, and limb dysfunction did not occur. Conclusions Pseudoaneurysms are most commonly resulted from the artery injuries caused by trauma, but the iatrogenic false has gradually increased. The early treatment and vascular repair can ensure the satisfactory effects. The color Doppler ultrasound plays an important role in the diagnosis of pseudoaneurysms, and the Magnetic Resonance Imaging ( MRI ) and angiography help clarify the diagnosis.