Lan Yong, Fu Wei-guo, Wang Yu-qi, Guo Da-qiao, Jiang Jun-hao, Chen Bin, Xu Xin, Yang Jue, Shi Zhen-yu
Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Zhonghua Wai Ke Za Zhi. 2007 Dec 1;45(23):1612-4.
To evaluate the efficacy of endovascular repair (EVR) for isolated iliac artery aneurysms (II AA).
Fourteen patients were treated with transluminally placed endovascular stent-grafts from October 2004 to May 2006. In eight patients, the aneurysms involved the right common iliac arteries. In five cases, left common iliac arteries were involved. The aneurysm involved the left internal iliac artery and ruptured in the other case. Criteria for repair were a diameter over 3.0 cm for true aneurysms.
Technical success was achieved in all cases. Eight cases with right common iliac artery aneurysms were treated with bifurcated aorto-iliac stent-grafts after ipsilateral internal iliac artery embolization with coils. One case with right common iliac artery aneurysm involved the bottom of abdominal aorta was treated with AUI stent-graft and femorofemoral bypass. Five cases involved left common iliac arteries were treated with tubular stent-grafts after ipsilateral internal iliac artery embolization with coils. One case with ruptured left internal iliac artery aneurysm was treated emergent with tubular stent-graft after ipsilateral internal iliac artery embolization with coils. Aortography carried out immediately after the procedure showed the II AA were completely excluded by stent-grafts and no serious endoleaks both on the proximal or distal connections. One case with acute left ventricular dysfunction and alveolar edema postoperatively recovered after emergent treatment No complications in thirteen cases. All patients were followed up for a mean of 10.2 months (3 to 19 months) by CTA, no aneurysms enlargement, no stent-grafts migration, no endoleak, femorofemoral bypass was patent.
Endovascular repair of isolated iliac artery aneurysms is a minimally invasive,safe and feasible technique and provides good short-term patency. Long-term patency is followed.
评估血管腔内修复术(EVR)治疗孤立性髂动脉瘤(II AA)的疗效。
2004年10月至2006年5月,14例患者接受了经皮腔内放置血管内支架移植物治疗。8例患者的动脉瘤累及右髂总动脉。5例累及左髂总动脉。1例患者的动脉瘤累及左髂内动脉并破裂。修复标准为真性动脉瘤直径超过3.0 cm。
所有病例均获得技术成功。8例右髂总动脉瘤患者在同侧髂内动脉用弹簧圈栓塞后,采用分叉型主动脉-髂动脉支架移植物治疗。1例右髂总动脉瘤累及腹主动脉下端的患者采用AUI支架移植物和股股旁路术治疗。5例累及左髂总动脉的患者在同侧髂内动脉用弹簧圈栓塞后,采用管状支架移植物治疗。1例左髂内动脉瘤破裂患者在同侧髂内动脉用弹簧圈栓塞后,急诊采用管状支架移植物治疗。术后立即进行的主动脉造影显示,II AA被支架移植物完全排除,近端或远端连接均无严重内漏。1例术后出现急性左心室功能障碍和肺泡水肿的患者经急诊治疗后康复。13例无并发症。所有患者平均随访10.2个月(3至19个月),通过CTA检查,无动脉瘤增大,无支架移植物移位,无内漏,股股旁路通畅。
孤立性髂动脉瘤的血管腔内修复术是一种微创、安全且可行的技术,短期通畅性良好。需随访长期通畅情况。