Rial R, Serrano Fj F j, Vega M, Rodriguez R, Martin A, Mendez J, Mendez R, Santos E, Gallego J
Department of Vascular Surgery, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain.
Eur J Vasc Endovasc Surg. 2004 Mar;27(3):333-5. doi: 10.1016/j.ejvs.2003.11.005.
The aim of this article is to report our experience in the use of a new technique for the treatment of type II endoleaks which appear after the endovascular treatment of abdominal aortic aneurysms.
In three patients with secondary type II endoleaks, we performed a translumbar puncture, introducing a 22-Gauge needle into the aneurysm sac under CT guidance. Once intrasac pressure had been registered, 1000U (2 ml) of human thrombin were slowly injected into the sac.
Complete sealing of the endoleak was achieved in all three patients, confirmed by the lack of contrast filling of the sac in the CT scans performed 5 min and 24 h after the procedure. Initial intrasac pressure was equal to systolic arterial pressure in the three patients. After the procedure, the pressure decreased by 30-40 mmHg. There were no complications during the procedure, which lasted 45-90 min. No endoleak recurrence has been observed in any of the three cases 6 months later.
We present an alternative method of treating type II endoleaks, which could become the treatment of choice if and when a wider experience confirms our initial good results.
本文旨在报告我们使用一种新技术治疗腹主动脉瘤血管内治疗后出现的Ⅱ型内漏的经验。
对3例继发性Ⅱ型内漏患者，在CT引导下经腰穿刺，将一根22号针插入动脉瘤腔内。记录腔内压力后，将1000U（2ml）人凝血酶缓慢注入腔内。
3例患者内漏均完全封闭，术后5分钟和24小时行CT扫描，显示腔内无造影剂充盈证实了这一点。3例患者最初的腔内压力与收缩期动脉压相等。术后压力下降了30 - 40mmHg。手术持续45 - 90分钟，期间无并发症发生。6个月后，3例患者均未观察到内漏复发。
我们提出了一种治疗Ⅱ型内漏的替代方法，如果更广泛的经验证实了我们最初的良好结果，该方法可能会成为首选治疗方法。
