血管内动脉瘤修复术后 II 型内漏胶栓塞后并发缺血性皮肤溃疡。

Ischemic skin ulceration complicating glue embolization of type II endoleak after endovascular aneurysm repair.

机构信息

Leeds Vascular Institute, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK.

出版信息

J Vasc Interv Radiol. 2011 Feb;22(2):163-7. doi: 10.1016/j.jvir.2010.10.018.

DOI:10.1016/j.jvir.2010.10.018

Abstract

The optimal treatment for type II endoleaks remains unclear. The present report describes a case of ischemic skin ulceration after glue embolization of a type II endoleak with challenging access in a multiply comorbid 82-year-old woman with an expanding aneurysm sac 3 years after endovascular aneurysm repair. Embolization was performed from a proximal position with an n-butyl cyanoacrylate/Ethiodol mixture to allow flow into the endoleak because direct sac puncture was hazardous. One week after intervention, an eschar, which progressed to superficial necrosis as a result of partial nontarget delivery of sclerosant, developed over the left iliac crest. The eschar was self-limiting, with complete resolution by 6 months.

摘要

Ⅱ型内漏的最佳治疗方法仍不清楚。本报告描述了一例 82 岁多重合并症女性患者在血管内动脉瘤修复后 3 年，因囊腔扩张行Ⅱ型内漏胶栓塞治疗后出现难以进入的缺血性皮肤溃疡。栓塞剂采用 n-丁基氰基丙烯酸酯/碘化油混合物从近端位置注入，以允许血流进入内漏，因为直接囊腔穿刺是有风险的。干预治疗后 1 周，在左髂嵴上出现了一个焦痂，由于硬化剂的部分非靶向输送导致浅表坏死。焦痂自行局限，6 个月后完全愈合。