Schneidereit Nathan P, Lee Shung, Morris D Christopher, Chen Jerry C
Division of General Surgery, Vancouver General Hospital, University of British Columbia, Canada.
J Endovasc Ther. 2003 Feb;10(1):71-4. doi: 10.1177/152660280301000115.
To describe the percutaneous treatment of a ruptured renal artery aneurysm (RAA) using a stent-graft.
An 86-year-old woman had sudden onset of right-sided back pain and a swollen left leg. Computed tomography disclosed a right retroperitoneal mass involving the kidney; the inferior vena cava was compressed, with thrombus in the left common iliac artery. There was a suggestion of RAA associated with contrast extravasation. Angiography confirmed a saccular aneurysm of the distal right main renal artery immediately proximal to the first segmental branch. A Jostent peripheral stent-graft was implanted with complete exclusion of the lesion. At 6-month follow-up, the patient remained asymptomatic, but there was a suggestion of in-stent restenosis, which is being followed closely.
In elderly patients who are hemodynamically stable and have aneurysm anatomy that is suitable for stent-graft placement, the endovascular approach may allow rapid and definitive treatment of the hemorrhage.
描述使用覆膜支架经皮治疗破裂性肾动脉动脉瘤（RAA）。
一名86岁女性突发右侧背痛和左腿肿胀。计算机断层扫描显示右肾旁后间隙肿块累及肾脏；下腔静脉受压，左髂总动脉有血栓形成。提示存在与造影剂外渗相关的RAA。血管造影证实右肾主动脉远端在第一分支段近端有一个囊状动脉瘤。植入了一个Jostent外周覆膜支架，病变完全被隔绝。在6个月的随访中，患者无症状，但提示有支架内再狭窄，正在密切观察。
对于血流动力学稳定且动脉瘤解剖结构适合放置覆膜支架的老年患者，血管内治疗方法可实现对出血的快速、确定性治疗。
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