Redman A, Cope L, Uberoi R
Department of Radiology, Queen Elizabeth Hospital, Sheriff Hill, Gateshead, Tyne & Wear NE9 6SX, UK.
Cardiovasc Intervent Radiol. 2001 Mar-Apr;24(2):113-6. doi: 10.1007/s002700001736.
Iliac rupture and aneurysm formation at the site of stent placement has rarely been described in the literature. We report four cases, three of iliac rupture, including a delayed rupture, and an aneurysm, with the use of a single type of stent, the Memotherm stent. We believe the design of the stent significantly contributed to damage to the arterial wall and subsequently prevented closure of the arterial tear by balloon tamponade in the two cases where this was attempted. Two patients, one with rupture and one with an aneurysm, were successfully treated with a covered stent obviating surgery and two ruptures resulted in death. We recommend that all interventionists carrying out iliac angioplasty and/or stenting should have access to covered stents for such emergencies.
文献中很少描述髂动脉破裂以及支架置入部位形成动脉瘤的情况。我们报告了4例病例,其中3例为髂动脉破裂,包括1例延迟破裂,1例为动脉瘤,均使用了同一种支架,即Memotherm支架。我们认为,支架的设计对动脉壁损伤有显著影响,在尝试进行球囊压迫止血的2例病例中,导致动脉撕裂未能闭合。2例患者,1例破裂,1例动脉瘤,成功接受了覆膜支架治疗,避免了手术,另外2例破裂导致死亡。我们建议,所有进行髂动脉血管成形术和/或支架置入术的介入医生应备有覆膜支架以应对此类紧急情况。