Sanada Junichiro, Matsui Osamu, Arakawa Fumitaka, Tawara Mari, Endo Tamao, Ito Hiroshi, Ushijima Satoshi, Endo Masamitsu, Ikeda Masahiro, Miyazu Katsuyuki
Department of Radiology, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
Cardiovasc Intervent Radiol. 2005 Jan-Feb;28(1):83-6. doi: 10.1007/s00270-004-0005-9.
We report two cases of acutely infected pseudoaneurysms of the iliac arteries, successfully treated with endovascular stent-grafting. Two patients underwent stent-graft treatment for erosive rupture of the iliac artery caused by surrounding infection. The first case is that of a 61-year-old man who had undergone Miles' operation for an advanced rectal cancer. Postoperatively, he developed intrapelvic abscess formation, from which methicillin-resistant Staphylococcus aureus was cultured, followed by rupture of the right external iliac artery. The second case is that of a 60-year-old man who had a pseudoaneurysm of the left common iliac artery, which was contiguous with a left psoas muscle abscess, from which Streptococcus agalactiae was cultured. Both patients were successfully treated with only a stent-graft and antibiotic therapy, and remained symptom-free 12 months and 10 months later. Although endovascular stent-grafting should not be considered standard therapy for infected aneurysms, our cases suggest that it can result in repair of infected aneurysms even in the uncontrolled active stage.
我们报告两例髂动脉急性感染性假性动脉瘤,经血管内支架植入术成功治疗。两名患者因周围感染导致髂动脉糜烂破裂而接受了支架植入治疗。第一例是一名61岁男性,因晚期直肠癌接受了腹会阴联合切除术。术后,他出现盆腔内脓肿形成,从中培养出耐甲氧西林金黄色葡萄球菌,随后右髂外动脉破裂。第二例是一名60岁男性,患有左髂总动脉假性动脉瘤,与左腰大肌脓肿相邻,从中培养出无乳链球菌。两名患者仅通过支架植入和抗生素治疗均获成功,12个月和10个月后均无症状。尽管血管内支架植入术不应被视为感染性动脉瘤的标准治疗方法,但我们的病例表明,即使在未控制的活动期,它也可以实现感染性动脉瘤的修复。