CAJ | 학술논문

目的总结腘动脉陷迫综合征(popliteal artery entrapment syndrome,PAES)的诊断和手术治疗经验.方法回顾性分析2002-2009年收治的10例(13条患肢)腘动脉陷迫综合征的临床资料,病程20 d至2年,平均(5±7)个月.9例以不同程度的间歇性跛行为始发症状,经数字减影造影(digital subtraction angiography,DSA)、计算机断层扫描血管成像(computed tomographic angiogram,CTA)、磁共振血管成像(magnetic resonance angiogram,MRA)检查或者术中确诊,10例患者均经手术治疗.结果患者发病年龄17～41岁,平均(25±7)岁.间歇性跛行是主要临床症状(9例,12条肢体),手术方式:肌切除、腘动脉松解术1例,股动脉切开取栓、腘动脉病变段球囊扩张术1例,肌切除、腘动脉切开取栓、内膜剥脱、大隐静脉补片成型术2例,取自体大隐静脉间置或旁路移植术6例,人工血管间置或旁路移植术3例.所有患者均得到随访,随访时间(35±27)个月(2个月至7年),患者无术中和术后长期并发症,临床症状无复发.结论 PAES是一种少见疾病,腘动脉松解、血管旁路或者血管重建等手术治疗是较好的选择.
목적 총결객동맥함박종합정(popliteal artery entrapment syndrome,PAES)적진단화수술치료경험.방법 회고성분석2002-2009년수치적10례(13조환지)객동맥함박종합정적림상자료,병정20 d지2년,평균(5±7)개월.9례이불동정도적간헐성파행위시발증상,경수자감영조영(digital subtraction angiography,DSA)、계산궤단층소묘혈관성상(computed tomographic angiogram,CTA)、자공진혈관성상(magnetic resonance angiogram,MRA)검사혹자술중학진,10례환자균경수술치료.결과 환자발병년령17～41세,평균(25±7)세.간헐성파행시주요림상증상(9례,12조지체),수술방식:기절제、객동맥송해술1례,고동맥절개취전、객동맥병변단구낭확장술1례,기절제、객동맥절개취전、내막박탈、대은정맥보편성형술2례,취자체대은정맥간치혹방로이식술6례,인공혈관간치혹방로이식술3례.소유환자균득도수방,수방시간(35±27)개월(2개월지7년),환자무술중화술후장기병발증,림상증상무복발.결론 PAES시일충소견질병,객동맥송해、혈관방로혹자혈관중건등수술치료시교호적선택.
Objective To summarize our experience in the diagnosis and management of popliteal artery entrapment syndrome (PAES). Methods This is a retrospective study on 10 patients (13 limbs)who were admitted for symptoms of claudication and the diagnosis of popliteal entrapment was established either with angiography,computed tomographic angiography,magnetic resonance angiogram or during the operation in recent 7 years (2002-2009).All patients were treated surgically. Results The mean age at the time of presentation was (25 ±7) years old (range,17-41 years).Claudication was the most frequent presenting symptom (12 limbs).The surgical procedures consisted of simple musculotendinous dissociation in 1 limb,thrombectomy with balloon angioplasty in 1 limb,musculotendinous dissociation plus thromboendarterectomy with autogenous saphenous vein (ASV)patch angioplasty in 2 limbs,ASV graft interposition or bypass in 6 limbs and graft interposition or bypass in 3 limbs.At a median follow-up of (35 ±27) months (range,2 months-7 years),there were no intraoperative or long-term postoperative complications and all the patients were cured. Conclusions PAES is an unusual but important cause of peripheral vascular insufficiency especially in young patients.A combined approach is necessary for diagnosis.Popliteal artery release alone or with vein bypass or reconstruction is the treatment of choice.