Huang Wan-Yi, Huang Chia-Yen, Chen Chi-An, Hsieh Chang-Yao, Cheng Wen-Fang
Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2008 Apr;107(4):348-51. doi: 10.1016/S0929-6646(08)60098-4.
The formation of pseudoaneurysms in patients with gynecologic malignancies is rare. We describe a patient with locally advanced cervical cancer who had life-threatening rectal bleeding due to a ruptured pseudoaneurysm of the right external iliac artery, which was successfully treated by emergent endovascular covered stent placement. This 56-year-old woman had received concurrent chemoradiation, salvage hysterectomy and systemic chemotherapy for advanced cervical cancer. About 25 months after her diagnosis of cervical cancer, she suffered from acute life-threatening rectal bleeding. Angiography revealed active extravasation from a pseudoaneurysm of the right external iliac artery. A covered stent was placed across the pseudoaneurysm via an endovascular approach to stop the bleeding. The patient recovered well without any sequelae. We believe that this technique might also be useful in other irradiated gynecologic cancer patients, especially when direct surgical repair is difficult to perform due to pelvic irradiation or tumor recurrence.
妇科恶性肿瘤患者中假性动脉瘤的形成较为罕见。我们报告一例局部晚期宫颈癌患者，因右侧髂外动脉假性动脉瘤破裂导致危及生命的直肠出血，通过紧急血管内覆膜支架置入成功治疗。这名56岁女性因晚期宫颈癌接受了同步放化疗、挽救性子宫切除术和全身化疗。在她被诊断为宫颈癌约25个月后，出现了危及生命的急性直肠出血。血管造影显示右侧髂外动脉假性动脉瘤有活动性出血。通过血管内途径在假性动脉瘤处放置覆膜支架以止血。患者恢复良好，无任何后遗症。我们认为该技术在其他接受过放疗的妇科癌症患者中可能也有用，尤其是当由于盆腔放疗或肿瘤复发而难以进行直接手术修复时。
