Estes J M, Halin N, Kwoun M, Burch J, England M, Mackey W C
Department of Surgery, New England Medical Center/Tufts University School of Medicine, Boston, MA 02111, USA.
J Vasc Surg. 2001 Mar;33(3):650-3. doi: 10.1067/mva.2001.111739.
Endograft treatment of aortic aneurysms has become a common procedure in many centers. However, not all patients are candidates for this new technology, because of their vascular anatomy and device limitations. One common problem is iliofemoral occlusive disease, which when present, even in a moderate degree, may preclude introduction of the large-diameter delivery devices currently in use. We present a case of a high-risk male patient with a thoracic aortic aneurysm and severe occlusive disease of the iliac arteries. An alternative approach for device delivery through the carotid artery was used and the procedure was successful with no neurologic complications. We recommend this technique for highly selected patients with an aneurysm who can undergo tube endograft repair without feasible access through the iliac or femoral arteries.
主动脉瘤的腔内修复术在许多中心已成为一种常见手术。然而，并非所有患者都适合这项新技术，这是由于其血管解剖结构和器械限制。一个常见问题是髂股闭塞性疾病，一旦出现，即使程度较轻，也可能妨碍目前使用的大口径输送器械的置入。我们报告一例高危男性患者，患有胸主动脉瘤和严重的髂动脉闭塞性疾病。采用了一种通过颈动脉进行器械输送的替代方法，手术成功，无神经并发症。我们推荐将该技术用于经过严格筛选的动脉瘤患者，这些患者无法通过髂动脉或股动脉进行可行的入路来接受覆膜支架腔内修复术。
