Surgical Treatment of Complicated Traumatic Arterial Aneurysm and Arteriovenous Fistula_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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乔正荣 , 时德 , 戴毅 , 蒋鸥 , 王志刚

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Keywords：

动脉瘤; 动静脉瘘; 创伤; 外科治疗

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目的探讨复杂的创伤性动脉瘤（TAA）和动静脉瘘（TAVF）的手术方法和疗效。方法对我院1963年6月至2000年12月经手术治疗的TAA和TAVF 121例进行回顾性分析。结果TAA ７１例含９１个动脉瘤，TAVF ５０例含５４个动静脉瘘。手术方式包括瘤体切除和端端吻合或血管移植或上下结扎，瘤体上下结扎加血管旁路移植，直接修补或补片。瘘管切除加四头结扎或动静脉移植或动静脉修补，介入栓塞治疗。死亡１例。TAA、TAVF随访率分别为６５.７%和６０.0%。远期效果好。结论不同部位复杂的TAA和TAVF应根据其不同分型采用不同的手术方式，对选择性病例可考虑做介入治疗。

Citation： 乔正荣,时德,戴毅,蒋鸥,王志刚. Surgical Treatment of Complicated Traumatic Arterial Aneurysm and Arteriovenous Fistula. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2004, 11(4): 314-316. doi: Copy

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2.	Coldwell DM, Novak Z, Ryu RK, et al. Treatment of posttraumatic internal carotid arterial pseudoaneurysms with endovascular stents [Ｊ]. J Trauma, 2000; 48(3)∶470.
3.	Luo CB, Lirng JF, Teng MM, et al. Endovascular embolization of arteriovenous fistulas of the external carotid artery [Ｊ]. Zhonghua Yi Xue Za Zhi (Taipei), 1998; 61(5)∶260.
4.	Kirchgatterer A, Baldinger C, Lenglinger F, et al. Portal hypertension due to traumatic hepatic arterioportal fistula: report of successful embolization [Ｊ]. Eur J Gastroenterol Hepatol, 1998; 10(12)∶1057.
5.	Balci NC, Semelka RC, Sandhu JS. Intrahepatic arterioportal fistula: gadoliniumenhanced 3D magnetic resonance angiography findings and angiographic embolization with steel coils [Ｊ]. Magn Reson Imaging, 1999; 17(3)∶475.
6.	Davis KA, Fabian TC, Croce MA, et al. Improved success in nonoperative management of blunt splenic injuries: embolization of splenic artery pseudoaneurysms [Ｊ]. J Trauma, 1998; 44(6)∶1008.
7.	Maloo MK, Burrows PE, Shamberger RC. Traumatic splenic arteriovenous fistula: splenic conservation by embolization [Ｊ]. J Trauma, 1999; 47(1)∶173.
8.	Wang KT, Hou CJ, Hsieh JJ, et al. Late development of renal arteriovenous fistula following gunshot traumaa case report [Ｊ]. Angiology, 1998; 49(5)∶415.
9.	Reber PU, Baer HU, Patel AG, et al. Superselective microcoil embolization: treatment of choice in highrisk patients with extrahepatic pseudoaneurysms of the hepatic arteries [Ｊ]. J Am Coll Surg, 1998; 186(3)∶325.
10.	Sharma S, Bhargava B, Mahapatra M, et al. Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stentgraft placement [Ｊ]. Eur Radiol, 1999; 9(3)∶422.
11.	Thalhammer C, Kirchherr AS, Uhlich F, et al. Postcatheterization pseudoaneurysms and arteriovenous fistulas: repair with percutaneous implantation of endovascular covered stents [Ｊ]. Radiology, 2000; 214(1)∶127.

1. 时德，张依仁，刘象和，等. 创伤性动脉瘤和动静脉瘘 [Ｊ]. 中华创伤杂志， 1996； 12（4）∶215.
2. Coldwell DM, Novak Z, Ryu RK, et al. Treatment of posttraumatic internal carotid arterial pseudoaneurysms with endovascular stents [Ｊ]. J Trauma, 2000; 48(3)∶470.
3. Luo CB, Lirng JF, Teng MM, et al. Endovascular embolization of arteriovenous fistulas of the external carotid artery [Ｊ]. Zhonghua Yi Xue Za Zhi (Taipei), 1998; 61(5)∶260.
4. Kirchgatterer A, Baldinger C, Lenglinger F, et al. Portal hypertension due to traumatic hepatic arterioportal fistula: report of successful embolization [Ｊ]. Eur J Gastroenterol Hepatol, 1998; 10(12)∶1057.
5. Balci NC, Semelka RC, Sandhu JS. Intrahepatic arterioportal fistula: gadoliniumenhanced 3D magnetic resonance angiography findings and angiographic embolization with steel coils [Ｊ]. Magn Reson Imaging, 1999; 17(3)∶475.
6. Davis KA, Fabian TC, Croce MA, et al. Improved success in nonoperative management of blunt splenic injuries: embolization of splenic artery pseudoaneurysms [Ｊ]. J Trauma, 1998; 44(6)∶1008.
7. Maloo MK, Burrows PE, Shamberger RC. Traumatic splenic arteriovenous fistula: splenic conservation by embolization [Ｊ]. J Trauma, 1999; 47(1)∶173.
8. Wang KT, Hou CJ, Hsieh JJ, et al. Late development of renal arteriovenous fistula following gunshot traumaa case report [Ｊ]. Angiology, 1998; 49(5)∶415.
9. Reber PU, Baer HU, Patel AG, et al. Superselective microcoil embolization: treatment of choice in highrisk patients with extrahepatic pseudoaneurysms of the hepatic arteries [Ｊ]. J Am Coll Surg, 1998; 186(3)∶325.
10. Sharma S, Bhargava B, Mahapatra M, et al. Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stentgraft placement [Ｊ]. Eur Radiol, 1999; 9(3)∶422.
11. Thalhammer C, Kirchherr AS, Uhlich F, et al. Postcatheterization pseudoaneurysms and arteriovenous fistulas: repair with percutaneous implantation of endovascular covered stents [Ｊ]. Radiology, 2000; 214(1)∶127.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Surgical Treatment of Complicated Traumatic Arterial Aneurysm and Arteriovenous Fistula

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