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Medicinski pregled
2018, vol. 71, br. 3-4, str. 125-129
Velika idiopatska pseudoaneurizma poplitealne arterije - prikaz slučaja
Budinski Slavko, Nikolić Dragan, Pasternak Janko
Klinički centar Vojvodine, Klinika za vaskularnu i transplantacionu hirurgiju, Novi Sad, Srbija

e-adresa: slavko.budinski@unc.ac.rs, janko.pasternak@mf.uns.ac.rs
Ključne reči: pseudoaneurizma; poplitealna arterija; endovaskularne procedure; implantacija vaskularne proteze; znaci i simptomi; dijagnoza
Sažetak
Uvod. Pseudoaneurizma, poznata i kao 'lažna' aneurizma, je kada krv prolazi kroz pojedine slojeve krvnog suda ili kroz sve slojeve, ali je zadržana okolnim mekim tkivom. Najčešci uzrok pseudoaneurizme je trauma, infekcija i prethodne medicinske procedure, ali postoje retki slučajevi kada uzrok nije pronađen. Prikaz slučaja. Ovaj rad je prikaz rekonstruktivne hirugije u slučaju velike idiopatske pseudaneurizme II segmenta poplitealne arterije kod 41-godišnjeg pacijenta, kojeg je uputio ortoped sa urađenom magnetnom rezonancijom leve noge. Anamnestički sa pojavom bola unazad tri nedelje, a otoka tkiva u levoj zatkolenoj jami unazad oko 6 meseci, a u kliničkom nalazu u toku pregleda je dominirala velika, bolna, nepulsatilna tumorska masa u levoj zatkolenoj jami koja je dovela do fleksne kontrakture kolena od 90 stepeni. Magnetna rezonancija je prikazala pseudoaneurizmu leve poplitealne arterije, te je hitno načinjena kompjuterizovana tomografska angiografija koja je potvrdila da je reč o pseudoaneurizmi drugog segmenta poplitealne arterije leve noge, bez znakova obliterativne bolesti. Intraoperativno je primenjen zadnji pristup i ekspozicija poplitealne arterije, a sa velikom safenskom venom desne noge načinjen je autovenski interponat. Zaključak. Rana dijagnostika ima važnu ulogu u sprečavanju privremenih i trajnih komplikacija. Rekonstrukcija arterije sa autovenskim graftom je zlatni standard i metoda izbora u hirurgiji pseudaneurizme poplitealne arterije. Privremeno postavljanje okluzivnih Fogartijevih katetera smanjuje oštećenje okolnog tkiva, ubrzava kontrolu krvarenja što zajedno skraćuje i vreme operacije.
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O članku

jezik rada: engleski
vrsta rada: prikaz slučaja
DOI: 10.2298/MPNS1804125B
objavljen u SCIndeksu: 02.08.2018.

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