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主动脉横断术及转流旁路手术治疗白塞病患者反复复发性腹主动脉假性动脉瘤破裂

Aortic transection and diverting bypass as treatment of repetitive recurrent abdominal aortic false aneurysm rupture in a patient with Behcet's disease.

作者信息

Kim Sang-Dong, Won Yong-Sung, Yun Sang-Seob, Park Sun-Cheol, Kim Ji-Il, Moon In-Sung, Koh Yong-Bok

机构信息

Department of Surgery, The Catholic University Medical Center, Seoul, Korea.

出版信息

Ann Vasc Surg. 2011 Feb;25(2):267.e1-5. doi: 10.1016/j.avsg.2010.07.022. Epub 2010 Oct 8.

Abstract

Abdominal aortic false aneurysms in patients with Behcet's disease have been reported frequently and repaired successfully by various procedures; however, anastomotic false aneurysms have often been reported to occur after the operation. In this article, we report a case of four-time repetitive, recurrent suprarenal abdominal aortic false aneurysm ruptures that lasted for 7 years. The location of this aneurysm was not easy to repair not only by open surgical procedures but by endovascular stent because the aortic defect was too close to the visceral arterial branches. The last operation consisted of primary repair of aortic defect, transection of abdominal aorta at the level of supraceliac aorta with end closure, and a thoracic aorta to abdominal aorta bypass with Dacron graft. An 8-year follow-up revealed no more abdominal aortic aneurysm recurrence.

摘要

白塞病患者腹主动脉假性动脉瘤的报道屡见不鲜,且已通过各种手术成功修复;然而,吻合口假性动脉瘤常在术后发生。在本文中,我们报告了一例持续7年的肾上腺上方腹主动脉假性动脉瘤四次反复破裂的病例。该动脉瘤的位置不仅难以通过开放手术修复,也难以通过血管内支架修复,因为主动脉缺损离内脏动脉分支太近。最后一次手术包括主动脉缺损的一期修复、在腹腔干上方水平横断腹主动脉并进行端端缝合,以及用涤纶人工血管进行胸主动脉至腹主动脉旁路移植术。8年的随访显示腹主动脉瘤未再复发。

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