Bush R L, Lin P H, Ronson R S, Conklin B S, Martin L G, Lumsden A B
Joseph B. Whitehead Department of Surgery, Division of Vascular Surgery, Emory University School of Medicine, Emory University Hospital, Atlanta, GA, USA.
J Vasc Surg. 2001 Dec;34(6):1119-22. doi: 10.1067/mva.2001.118824.
The optimal management of endoleaks after endovascular repair of abdominal aortic aneurysms remains to be established. In this report, we describe a persistent side-branch, or type II, endoleak 1 year after endograft implantation treated with catheter-directed embolization of the aneurysm sac and the inferior mesenteric artery via the superior mesenteric artery, with embolization agents including thrombin, lipiodol, and gelfoam powder. Shortly after the embolization procedure, colonic necrosis developed in the patient, manifested by peritonitis, which necessitated a partial colectomy. This case underscores the devastating complication of colonic ischemia as a result of catheter-directed embolization of the inferior mesenteric artery in the management of an endoleak.
腹主动脉瘤血管内修复术后内漏的最佳管理方法仍有待确定。在本报告中，我们描述了1例在植入血管内移植物1年后出现的持续性侧支或II型内漏，通过经肠系膜上动脉对瘤腔和肠系膜下动脉进行导管定向栓塞治疗，栓塞剂包括凝血酶、碘油和明胶海绵粉。栓塞术后不久，患者出现结肠坏死，表现为腹膜炎，需要进行部分结肠切除术。该病例强调了在处理内漏时，经导管对肠系膜下动脉进行栓塞导致结肠缺血这一严重并发症。
