教員業績データベース |
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論文種別 | 原著 |
言語種別 | 英語 |
査読の有無 | 査読なし |
表題 | Significance of preoperative 3D-CT angiography for localization of the femoral artery in complicated THA. |
掲載誌名 | 正式名:Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 略 称:J Orthop Sci ISSNコード:1436-2023(Electronic)0949-2658(Linking) |
巻・号・頁 | 19,pp.457-464 |
著者・共著者 | Fukunishi Shigeo, Okahisa Shohei, Fukui Tomokazu, Nishio Shoji, Fujihara Yuki, Takeda Yu, Yoshiya Shinichi |
発行年月 | 2014/05 |
概要 | BACKGROUND:Major vascular injury is one of the most devastating complications in total hip arthroplasty (THA). Risk for intraoperative vascular injury is increased when the normal vascular anatomy is distorted by previous surgery or dislocation with displacement. Therefore, an appreciation of the vascular anatomy in relation to the anticipated surgical field is critical to avoid this complication during preoperative assessment for a complicated THA.METHODS:Preoperative three-dimensional (3D) CT angiography was performed for 24 complicated THAs when altered vascular anatomy around the acetabulum was suspected. When assessing the CT images, the presence of apparent proliferation of vessels close to the original acetabulum as well as a distance ofMETHODS:<METHODS:10 mm from the artery to the acetabulum was deemed a potential risk factor for intraoperative vascular injury. Additionally, the relationships of clinical characteristics and the presence of these risk factors were analyzed to identify the patient population at risk.RESULTS:The incidence of proliferation of collateral vessels was higher in patient groups with proximal femoral migration of 5 cm or more and multiple previous surgeries prior to the index THA. Moreover, in three ankylosed hips, lateral deviation of the main vascular trunk with an artery-acetabulum distance ofRESULTS:<RESULTS:10 mm was identified in all cases.CONCLUSION:Preoperative 3D-CT angiography in cases of complicated THA revealed altered vascular anatomy which may increase the risk for intraoperative vascular injuries. Patient characteristics related to the risk for this complication were marked proximal femoral migration, multiple previous surgeries, and hip ankylosis. Preoperative image examination of the vascular anatomy is thought to help reduce the risk of inadvertent vascular injury in these complicated THA cases. |
DOI | 10.1007/s00776-014-0542-2 |
文献番号 | 24532365 |