How is treatment for Aneurysm?
1. Surgery should be done after the full establishment of collateral circulation (generally aneurysms occur in 3 to 6 months). If the conditions of arterial grafting, surgery may be done in advance.
2. The condition that should an emergency operation:
aneurysm rupture or rupture of the rapid increasing tendency of those who have;
tumor of the distal limb or serious brain tissue affected by ischemia or physical survival when life-threatening brain damage;
infected aneurysm;
severe oppression at the neighboring tissues and organs;
have formed dissection.
3. Surgical methods:
aneurysm resection, arterial to end anastomosis or vascular graft. Carotid artery surgery Matas test before surgery using hypothermia anesthesia, blocking blood flow to minimize the duration of time, or temporary inside and outside the bypass in order to maintain blood perfusion in brain tissue.
endovascular aneurysm repair. For pseudoaneurysm or aneurysm with the adjacent nerves, blood vessels are close adhesion.
tangential excision aneurysm, artery repair. For cystic bulging of the aneurysm.
cyst aneurysm surgery. For aneurysms in patients with unresectable or resection can not be tolerated.
aneurysm proximal and distal artery ligation, autologous vein bypass graft anatomy spaces, drainage cavity tumors. For infectious aneurysms.
How is preoperative preparation for Aneurysm?
1. To promote the formation of collateral circulation can be used the following methods:
repression of the proximal artery aneurysm, a day several times, each time from oppression increasing 2 ~ 5min to 30min, the absence of physical symptoms and normal blood circulation, then there is sufficient proof of the formation of collateral circulation.
sympathetic ganglion block, upper limb for stellate ganglion block, lumbar sympathetic ganglia of lower limb for the block.
the proper use of limb massage, and heat wave.
2. In traumatic aneurysm, take 1d antibiotics before surgery. If there are retained foreign body, in preoperative and postoperative, should be 3000U serum anti tetanus injection.
3. With 400 ~ 1500ml blood reserve.
4. To prepare for the vascular graft.
Which attention is in intraoperative for Aneurysm?
1. The first show Artery proximal, and with tourniquet to control bleeding.
2. As far as possible retain the collateral circulation to reduce the chance of limb necrosis.
3. Artery stump need ligation of double and takes 1st suturing, complete hemostasis; strict enforcement of aseptic technique to prevent postoperative infection, so as not to lead to secondary haemorrhage.
How to process for Aneurysm postoperation?
1. In addition to the attention of the whole body cases, limb should be checked daily cycle, the detailed records, to maintain good limb until the cycle.
2. If the phenomenon of poor circulation, according to the following method:
Placed limb to 15cm below the heart, if there is swelling, need to run-up limb at a short period of time daily (about 30 °) on several occasions.
the elimination of all possible factors that cause vascular spasm, such as pain, mental stress, smoking, cold, etc..
aneurysms, particularly abdominal aortic aneurysm, postoperative limb ischemia, a common cause of lower extremity arterial thromboembolism for (spam feet), as soon as possible Fogarty catheter thrombectomy line and thrombolytic therapy.
3. Should review discharge cycle limbs before leave hospital, observe symptoms of ischemia.
