Ratchford Elizabeth V, Morrissey Nicholas J
Vascular Medicine, Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA.
Vasc Endovascular Surg. 2006;40(6):487-91. doi: 10.1177/1538574406294076.
Endovascular repair provides a reasonable alternative to open repair for the treatment of abdominal aortic aneurysms in select cases. Although the endovascular approach may be preferable for inflammatory aneurysms, aggressive surveillance is needed to monitor for long-term complications. A 61-year-old man underwent endovascular exclusion of a symptomatic inflammatory abdominal aortic aneurysm with an AneuRx bifurcated aortic prosthesis. He presented with gastrointestinal bleeding 51/2 months later and was found to have an aortoenteric fistula involving the third portion of the duodenum. The aneurysm had expanded significantly at the proximal neck. The patient underwent successful removal of the device, aortic ligation, and extraanatomic bypass. Aortoenteric fistula is a rare but now established complication of endovascular aneurysm repair. The pathophysiology in these cases remains unclear. The presence of inflammation and endoleak may predispose to further aneurysmal degeneration.
对于某些特定病例，血管内修复术为腹主动脉瘤的治疗提供了一种合理的替代开放性修复的方法。尽管血管内治疗方法可能更适合炎性动脉瘤，但仍需要积极监测以长期监测并发症。一名61岁男性接受了使用AneuRx分叉型主动脉假体对有症状的炎性腹主动脉瘤进行血管内排除术。5个半月后，他出现胃肠道出血，发现患有累及十二指肠第三部分的主动脉肠瘘。动脉瘤近端颈部明显扩张。患者成功移除了装置，进行了主动脉结扎和解剖外旁路手术。主动脉肠瘘是血管内动脉瘤修复术一种罕见但已被确认的并发症。这些病例中的病理生理学仍不清楚。炎症和内漏的存在可能易导致进一步的动脉瘤退变。
