Mycotic aneurysm. New concepts in therapy.
Mycotic aneurysm. New concepts in therapy.
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霉菌性动脉瘤。
DOI：
10.1001/archsurg.1983.01390050053010
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发表时间：
1983
影响因子：
--
通讯作者：
C. Lucas
中科院分区：
文献类型：
--
作者：
Jeffrey R. Johnson;A. Ledgerwood;C. Lucas
50例患者接受了52例继发于静脉药物滥用的肌层动脉瘤治疗。17%的患者最初误诊为蜂窝织炎或脓肿，经动脉造影或手术引流后出血后得到纠正。桡动脉、肱动脉、髂外动脉、股深动脉和股浅动脉的动脉瘤结扎和切除后没有缺血。切除股总动脉4例，股动脉分叉25例，28例未同时进行血运重建的患者发病率明显。这些患者中有53%发生缺血，21%为轻度，仅伴有跛行。32%的患者发生严重的、威胁肢体的缺血，21%的患者导致截肢。6例患者接受了人工旁路，其中1例在结扎时无背部出血，4例立即严重缺血，1例晚期缺血。两个受感染的移植物被移除;另一个成为血栓。73%的动脉瘤和46%的患者血液培养呈阳性。
Fifty patients were treated for 52 mycotic aneurysms secondary to intravenous drug abuse. An initial misdiagnosis of cellulitis or abscess in 17% of the patients was corrected after arteriography or bleeding following operative drainage. There was no ischemia following ligation and excision of aneurysms of the radial, brachial, external iliac, deep femoral, and superficial femoral arteries. Excision of the common femoral artery in four patients and femoral bifurcation in 25 led to marked morbidity in 28 patients without simultaneous revascularization. Ischemia occurred in 53% of these patients; it was mild in 21% with claudication only. Severe, limb-threatening ischemia occurred in 32% and led to amputation in 21%. Six patients underwent artificial bypass, including one for absent back-bleeding at the time of ligation, four for immediate severe ischemia, and one for late ischemia. Two infected grafts were removed; another became thrombotic. Cultures were positive for 73% of aneurysms and blood of 46% of the patients.