腹主动脉瘤血管内修复术后4年，出现症状性动脉瘤破裂，无因内张力导致的继发出血。
Symptomatic aneurysm rupture without bleeding secondary to endotension 4 years after endovascular repair of an abdominal aortic aneurysm.
作者信息
Kougias Panagiotis, Bismuth Jean, Huynh Tam T, Lin Peter H
机构信息
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
出版信息
J Endovasc Ther. 2008 Dec;15(6):702-5. doi: 10.1583/08-2391.1.
PURPOSE
To demonstrate the absence of bleeding from a ruptured abdominal aortic aneurysm (AAA) without evidence of endoleak following endovascular aneurysm repair (EVAR).
CASE REPORT
A 72-year-old woman developed aneurysm enlargement 4 years after EVAR of an infrarenal AAA. During surgical exploration for abdominal pain and presumed aneurysm rupture, the ruptured aneurysm sac was found to be filled with gelatinous material without evidence of thrombus or active bleeding.
CONCLUSION
This case provides insight into the natural history of endotension and indicates that conservative management even in the face of an expanding aneurysm is a valid management option for selected patients.
目的
证明在血管内动脉瘤修复术（EVAR）后，腹主动脉瘤（AAA）破裂但无内漏迹象时不会出血。
病例报告
一名72岁女性在肾下AAA进行EVAR术后4年出现动脉瘤扩大。在因腹痛及推测动脉瘤破裂而进行手术探查时，发现破裂的动脉瘤腔内充满凝胶状物质，无血栓或活动性出血迹象。
结论
本病例有助于深入了解内张力的自然病程，并表明即使面对动脉瘤扩大，对于部分患者而言，保守治疗也是一种有效的治疗选择。
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