Sfyroeras G S, Moulakakis K G, Bessias N, Maras D, Tsanis A, Georgakis P, Andrikopoulos V
Department of Vascular Surgery, Red Cross Hospital, Athens, Greece.
Vasa. 2010 Feb;39(1):98-102. doi: 10.1024/0301-1526/a000011.
This report presents a case of type II endoleak after endovascular exclusion of a primary aortocaval fistula, producing renal vein hypertension and renal insufficiency. A 74-year-old patient presented with acute renal insufficiency, hematuria, lower limb edema, and weight gain. The abdominal CT scan revealed an abdominal aortic aneurysm and an aortocaval fistula. An endograft was deployed but type II endoleak was present and persisted after surgical ligation of the inferior mesenteric artery and subsequent unsuccessful attempt of coil-embolization. The patients renal function continued to be impaired. Surgical ligation of aortocaval communication with preservation of the endograft was performed, resulting in restored renal function.
本报告介绍了一例原发性主腔静脉瘘血管内封堵术后发生Ⅱ型内漏的病例，该内漏导致肾静脉高压和肾功能不全。一名74岁患者出现急性肾功能不全、血尿、下肢水肿和体重增加。腹部CT扫描显示腹主动脉瘤和主腔静脉瘘。植入了血管内支架移植物，但存在Ⅱ型内漏，在肠系膜下动脉手术结扎及随后的弹簧圈栓塞尝试失败后内漏仍持续存在。患者的肾功能持续受损。遂进行了保留血管内支架移植物的主腔静脉交通支手术结扎，肾功能得以恢复。
