Sfyroeras Giorgos S, Koutsias Stylianos, Karathanos Christos, Stamoulis Konstantinos, Giannoukas Athanassios D
Department of Vascular Surgery, University of Thessaly Medical School, Larissa, Greece.
Vasc Endovascular Surg. 2010 Oct;44(7):597-600. doi: 10.1177/1538574410369388. Epub 2010 May 18.
To present the first case of colonic ischemia (CI) after endovascular exclusion of an aortoiliac aneurysm using an iliac branch device (IBD).
A 69-year-old male patient with an abdominal aortic and right common iliac artery aneurysm underwent endovascular repair with an IBD. Completion angiography demonstrated good patency in 2 of the 3 main branches of the right internal iliac artery (IIA) whereas the left IIA patency was preserved. Preoperatively, the inferior mesenteric artery (IMA) was patent. Postoperatively, the patient presented moderate CI. He was treated conservatively and discharged 15 days later with recession of the symptoms.
Although preservation of bilateral iliac artery patency is considered to diminish the incidence of pelvic ischemia, in case of an exclusion of a patent IMA, collaterals may not be adequate to ensure blood supply to the left colon.
报告首例使用髂支装置（IBD）对主-髂动脉瘤进行血管腔内隔绝术后发生结肠缺血（CI）的病例。
一名69岁男性患者，患有腹主动脉瘤和右髂总动脉瘤，接受了IBD血管腔内修复术。完成血管造影显示，右髂内动脉（IIA）3个主要分支中的2个通畅，而左IIA通畅得以保留。术前，肠系膜下动脉（IMA）通畅。术后，患者出现中度CI。对其进行了保守治疗，15天后症状缓解出院。
尽管保留双侧髂动脉通畅被认为可降低盆腔缺血的发生率，但在IMA通畅却被隔绝的情况下，侧支循环可能不足以确保左半结肠的血液供应。
