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感染性髂动脉假性动脉瘤的血管内支架植入术。

Endovascular stent-grafting for infected iliac artery pseudoaneurysms.

作者信息

Sanada Junichiro, Matsui Osamu, Arakawa Fumitaka, Tawara Mari, Endo Tamao, Ito Hiroshi, Ushijima Satoshi, Endo Masamitsu, Ikeda Masahiro, Miyazu Katsuyuki

机构信息

Department of Radiology, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.

出版信息

Cardiovasc Intervent Radiol. 2005 Jan-Feb;28(1):83-6. doi: 10.1007/s00270-004-0005-9.

Abstract

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.

摘要

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。

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