초록접수 현황
| 17F-060 | 포스터 발표 |
Pseudoaneurysm of the Peroneal Artery after Surgical Embolectomy
Kwan Wook Kim, Chang Wan Kim, Chun Sung Byun, Soonchang Hong, Joong Hwan Oh
Department of Thoracic and Cardiovascular surgery, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Gangwon-do, Republic of Korea
Purpose : The surgical embolectomy is well established treatment for acute limb ischemia. In chronic situation, it can also be helpful in terms of symptom relief and amputation level decision. Iatrogenic pseudoaneurysm because of intimal damage from the embolectomy balloon is a rare complication. We report here a case of iatrogenic peroneal artery pseudoaneurysm after surgical embolectomy.
Methods : A 69-year-old man presented with a progressive left toes color change and several months history of claudication. Enhanced computed tomography (CT) of the lower extrimities disclosed total obstruction of left superficial femoral artery, mid-portion. Furthermore, the distal blood flow of arteries below this level were identified by collateral circulation.
Results : After vertical incision made on left inguinal area, common-, deep- and superficial femoral arteries were identified. The surgical embolectomy was successfully performed and a large amount of organized thrombus were extracted. Follow-up CT at postoperative day 1, revealed completely recovered left superficial femoral arterial flow with poor distal circulation and proximal peroneal artery about 1cm sized psedoaneurysm. We decided against taking more procedure. Because, the patient recovered from claudication shortly after the operation and not suffered blood loss from this lesion. However, irreversible damaged left toes necrosis were not recovered. He was discharged from the hospital on postoperative day 8. He was followed up at an outpatient clinic for 2 months without other complications.
Conclusion : A gentle technique is necessary to avoid intimal damage during surgical embolectomy. The usual management of this complication is further surgery. And also, thrombin injection and coil embolization are well established technique. However, conservative care can be a treatment option in not severe case selectively.
Methods : A 69-year-old man presented with a progressive left toes color change and several months history of claudication. Enhanced computed tomography (CT) of the lower extrimities disclosed total obstruction of left superficial femoral artery, mid-portion. Furthermore, the distal blood flow of arteries below this level were identified by collateral circulation.
Results : After vertical incision made on left inguinal area, common-, deep- and superficial femoral arteries were identified. The surgical embolectomy was successfully performed and a large amount of organized thrombus were extracted. Follow-up CT at postoperative day 1, revealed completely recovered left superficial femoral arterial flow with poor distal circulation and proximal peroneal artery about 1cm sized psedoaneurysm. We decided against taking more procedure. Because, the patient recovered from claudication shortly after the operation and not suffered blood loss from this lesion. However, irreversible damaged left toes necrosis were not recovered. He was discharged from the hospital on postoperative day 8. He was followed up at an outpatient clinic for 2 months without other complications.
Conclusion : A gentle technique is necessary to avoid intimal damage during surgical embolectomy. The usual management of this complication is further surgery. And also, thrombin injection and coil embolization are well established technique. However, conservative care can be a treatment option in not severe case selectively.
책임저자: Joong Hwan Oh
Department of Thoracic and Cardiovascular surgery, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Gangwon-do, Republic of Korea
발표자: Kwan Wook Kim, E-mail : mujin10km@yonsei.ac.kr