Diagnosis and management of concurrent abdominal aortic aneurysm and limb arterial stenosis

doi:10.3877/cma.j.issn.1674-0793.2010.06.009

Abstract

Abstract:

Objective

To investigate the management of concurrent abdominal aortic aneurysm (AAA) and limb artery stenosis.

Methods

The clinical data of 21 hospital patients with concurrent AAA and limb artery stenosis admitted to our hospital, between January 1991 and January 2010 were analyzed retrospectively.

Results

The incidence of concurrent AAA and limb artery stenosis increased with age. It was more frequent in male than in female. Fifteen patients were operated against AAA with open surgery or endovascular stent repair. Seven cases underwent limb arterial reconstruction by simultaneous or staged operations. Three cases died from multiple system organ failure (MSOF) with the mortality of 14%, all suffered by inappropriate management of the limbs, whose limbs went necrosis. One patient had amputation. Five patients were medically conservative treated.

Conclusion

Cautions should be paid to the diagnosis and management of concurrent AAA and limb artery stenosis due to the high mortality.

Key words: Aortic aneurysm, abdominal, Arteriosclerosis obliterans, Concurrent, Aged, Therapy

Jin-Song WANG, Zuo-jun HU, Song-qi LI, Heng-hui YIN, Guang-qi CHANG, Wei-ming LV, Xiao-xi LI, Shen-ming WANG. Diagnosis and management of concurrent abdominal aortic aneurysm and limb arterial stenosis[J]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(06): 539-541.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2010.06.009

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2010/V04/I06/539

Figures/Tables 1

References 8

1	Katz DJ,Stanley JC,Zeleneock GB. Gender differences in abdominal aortic aneurysm prevalence, treatment and outcome. J Vasc Surg, 1997, 25(3): 561-568.
2	Levy PJ. Epidemiology and pathophysiology of peripheral arterial disease. Clin Cornerstone, 2002, 4(5): 1-15.
3	Cacoub P,Cambou JP,Kownator S, et al. Prevalence of peripheral arterial disease in high-risk patients using ankle-brachial index in general practice: a cross-sectional study. Int J Clin Pract, 2009, 63(1): 63-70.
4	BrMacSweeney ST,O'Meara M,Alexander C, et al. High prevalence of unsuspected abdominal aortic aneurysm in patients with confirmed symptomatic peripheral or cerebral arterial disease. Br J Surg, 1993, 80(5): 582-584.
5	Barba A,Estallo L,Rodríguez L, et al. Detection of abdominal aortic aneurysm in patients with peripheral artery disease. Eur J Vasc Endovasc Surg, 2005, 30(5): 504-508.
6	Wanhainen A,Berqvist D,Björck M. Measuring the abdominal aorta with ultrasonography and computed tomography—difference and variability. Eur J Vasc Endovasc Surg, 2002, 24(5): 428-434.
7	Powell JT,Brown LC,Forbes JF, et al. Final 12-year follow-up of surgery versus surveillance in the UK small aneurysm trial. Br J Surg, 2007, 94(6): 702-708.
8	Madiba TE,Robbs JV. Aortofemoral bypass in the presence of total juxtarenal aortic occlusion. Eur J Vasc Surg, 1993,7(1): 77-81.

例数	治疗方案	预后
8	仅行AAA开放手术（人工血管与双侧股动脉吻合术）	1例术后严重下肢缺血、MSOF，死亡余7例恢复良好
1	1 . AAA开放手术（人工血管与双侧股动脉吻合术）	良好
1	2 .同期行一侧股-腘动脉人工血管旁路术（因下肢严重缺血）	良好
1	1 . AAA开放手术（人工血管与双侧股动脉吻合术）	死亡
1	2.12h后急诊行股-腘动脉人工血管旁路术（因下肢严重缺血）	死亡
1	1 . AAA开放手术（人工血管与双侧股动脉吻合术）	良好
1	2.分期股动脉超声消融术	良好
2	1 . AAA支架植入术	良好
2	2.同期或分期行股动脉内膜剥脱术	良好
1	1 . AAA支架植入术后，	人工血管感染，死亡
1	2 .分别行股股旁路，腋股旁路（因一侧下肢严重缺血）	人工血管感染，死亡
1	AAA支架植入术	良好
1	截肢（下肢严重缺血）	良好
5	保守治疗（因AAA瘤体<5 cm、下肢缺血为中度缺血或经济情况）	出院

例数	治疗方案	预后
8	仅行AAA开放手术（人工血管与双侧股动脉吻合术）	1例术后严重下肢缺血、MSOF，死亡余7例恢复良好
1	1 . AAA开放手术（人工血管与双侧股动脉吻合术）	良好
1	2 .同期行一侧股-腘动脉人工血管旁路术（因下肢严重缺血）	良好
1	1 . AAA开放手术（人工血管与双侧股动脉吻合术）	死亡
1	2.12h后急诊行股-腘动脉人工血管旁路术（因下肢严重缺血）	死亡
1	1 . AAA开放手术（人工血管与双侧股动脉吻合术）	良好
1	2.分期股动脉超声消融术	良好
2	1 . AAA支架植入术	良好
2	2.同期或分期行股动脉内膜剥脱术	良好
1	1 . AAA支架植入术后，	人工血管感染，死亡
1	2 .分别行股股旁路，腋股旁路（因一侧下肢严重缺血）	人工血管感染，死亡
1	AAA支架植入术	良好
1	截肢（下肢严重缺血）	良好
5	保守治疗（因AAA瘤体<5 cm、下肢缺血为中度缺血或经济情况）	出院

[1]	The Joint Surgery Branch of the Chinese Orthopedic Association, Guangdong’s Medical Association of Osteoporosis And Bone Mineral Research, Foshan Shunde 3rd Peoele’s Hospital. Clinical intervention guideline for using of anti-osteoporosis drugs in postoperative fragile hip fractures in China (2023 Edition) [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 751-764.
[2]	Yanhui Zhang, Jiao Zhang, Zhixian Zhu. Effect of indwelling anal tube on anastomotic leakage after laparoscopic total mesangectomy after neoadjuvant chemoradiotherapy in patients with middle and low rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 25-28.
[3]	Fengyi Li, Ruofan Li, Xu Gao, Chaofan Zhang. Effect of target-directed liquid intervention on postoperative hemodynamics and gastrointestinal function recovery in elderly patients with gastrointestinal tumors [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 29-32.
[4]	Bo Kong, Jing Zhang, Ke Lyu. Review on the role of ultrasonography in the diagnosis and treatment of complex ventral hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 670-673.
[5]	Xiaoyong Wei. Discussion on the focus issues of conversion therapy for primary liver cancer [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 602-607.
[6]	Chenrui Wu, Rui Liao, Qiang He. Hepatic arterial infusion chemotherapy combined immunotargeted therapy for multiple metastatic hepatocellular carcinoma in a multi-disciplinary treatment model: a case report [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 713-716.
[7]	Huiying Ma, Xinling Fan, Shirui Tan, Jiayun Chen, Ying Cao, Yuan Xu, Jing Jin, Yuan Tang. Magnetic resonance linac for locally advanced rectal cancer: a preliminary experience [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 519-523.
[8]	Guangjun Zhong, Chunhua Liu, Wansen Zhu, Xiaolei Xu, Zhaojun Wang. Application of conventional MRI combined with different scanning sequences in preoperative staging diagnosis, chemotherapy efficacy and prognosis evaluation of gastric cancer [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 378-382.
[9]	Qiujie Shan, Lizhu Sun, Yiquan Xu, Zhixia Wang, Yan Xu, Hao Ma, Tiantian Liu. Construction and application of radiation-induced lung injury risk model for middle-aged and elderly patients with esophageal cancer during intensity modulated radiotherapy [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 388-393.
[10]	Baoru Hu, Naijian Shang, Di Gao. DCE-MRI and DWI findings of advanced hepatocellular carcinoma and their correlation with prognosis after immunotherapy [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 399-403.
[11]	Xiankui Gao, Taiyun Zhao, Xingjun Lu, Hongling Zhang, Xiuluo Fang, Bichun Yan, Yin Wang, Yongcui Wang, Miaomiao Liu, Ruonan Ran. Efficacy of endoscopic electrocoagulation and tissue glue injection in the treatment of upper gastrointestinal ulcer with bleeding [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 452-455.
[12]	Chunhua Qiu, Zhihong Zhang. Clinical diagnosis and examination strategy for small intestinal diseases: analysis of 1108 cases [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 948-954.
[13]	Ruixue Yue, Lingxin Kong, Xin Hao, Jinqiang Yang, Meng Han, Guozhong Cui, Jianjun Wang, Zhisheng Zhang, Fanting Kong, Wei Zhang, Wenbo He, Xianqiao Li, Xinping Zhou, Donghong Xu, Chongzhu Hu. HER2 protein expression levels predict efficacy of neoadjuvant therapy in breast cancer: A real-world study [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(07): 765-770.
[14]	Yingqian Li, Huashan Li. Evaluation of treatment methods for complete rectal prolapse: a real world study [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 700-705.
[15]	Meisha Fu, Yuhua Zhou, Hui Li, Chunyan Xue. Effect of lymphocyte immunotherapy on T lymphocyte subset distribution and PD1/PD-L1 expression in patients with recurrent miscarriage [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 726-730.

Please choose a citation manager

Content to export