Coupe Nicholas J, Ling Lynn, Cowling Mark G, Asquith John R, Hopkinson Gregory B
Department of Radiology, University Hospital of North Staffordshire, City General Hospital, Russell Building, Newcastle Road, Stoke-on-Trent, 8 Meaford Avenue, Stone, Staffordshire, ST15 8LT, UK.
Cardiovasc Intervent Radiol. 2009 Jul;32(4):772-5. doi: 10.1007/s00270-009-9520-z. Epub 2009 Feb 12.
We report our initial experience using the Amplatzer Vascular Plug II (AVP2) in the treatment of a left common iliac aneurysm. Following investigation by computerized tomographic angiography and catheter angiography, a 79-year-old man was found to have a markedly tortuous iliac system, with a left common iliac artery aneurysm that measured 48 mm in maximal diameter. Due to the patient's age and comorbidities the surgical opinion was that conventional open repair was not suitable. However, due to the tortuous nature of the aneurysm and iliac vessels, standard endovascular repair, using either a bifurcated or an aorto-uni-iliac stent graft, was also not possible. A combined approach was used by embolizing the ipsilateral internal iliac artery using coils and excluding the aneurysm using two AVP2 occlusion devices, followed by femorofemoral crossover grafting. Total aneurysm occlusion was achieved using this method and this allowed the patient to have a much less invasive surgical procedure than with conventional open repair of common iliac aneurysms, thus avoiding potential comorbidity and mortality.
我们报告了使用Amplatzer血管封堵器II（AVP2）治疗左髂总动脉瘤的初步经验。经计算机断层血管造影和导管血管造影检查，发现一名79岁男性的髂血管系统明显迂曲，左髂总动脉瘤最大直径为48mm。鉴于患者的年龄和合并症，外科医生认为传统的开放修复不合适。然而，由于动脉瘤和髂血管的迂曲性质，使用分叉或主动脉-单髂支支架型人工血管进行标准的血管内修复也不可行。采用了一种联合方法，先用弹簧圈栓塞同侧髂内动脉，再用两个AVP2封堵装置排除动脉瘤，随后进行股-股交叉移植术。使用该方法实现了动脉瘤的完全闭塞，与传统的左髂总动脉瘤开放修复相比，该患者的手术侵入性小得多，从而避免了潜在的合并症和死亡率。
