Bloemsma Gijsbert C, van Oostayen Jacques A, Reijnen Michel M P J
Department of Radiology, Rijnstate Hospital, Arnhem, The Netherlands.
Ann Vasc Surg. 2012 Oct;26(7):1011.e11-3. doi: 10.1016/j.avsg.2012.01.015. Epub 2012 Jun 28.
The purpose of this study was to describe a case of an endovascular exclusion of a ruptured type II renal artery aneurysm in a hemodynamically unstable patient using an endograft.
A 73-year-old woman, with an extensive medical history, presented with a sudden onset of abdominal pain and hypovolemic shock. A computed tomography scan showed a massive right-sided retroperitoneal hematoma and a type II aneurysm of the right renal artery just proximal to the bifurcation. Angiography demonstrated active contrast extravasation from the aneurysm. The aneurysm was excluded using a 5-cm long, 6-mm wide endograft. After a 6-month interval, duplex ultrasonography showed a patent endograft and normal perfusion of the renal parenchyma in the lower and middle pole, with a glomerular filtration rate of 75 mL/min.
Endovascular exclusion using an endograft may provide a safe and rapid alternative to surgery to treat ruptured renal artery aneurysms in a selected group of patients.
本研究的目的是描述一例使用血管内移植物对血流动力学不稳定的患者进行破裂性Ⅱ型肾动脉动脉瘤血管内封堵的病例。
一名73岁女性，有复杂病史，突发腹痛和低血容量性休克。计算机断层扫描显示右侧巨大腹膜后血肿以及右肾动脉在分叉近端的Ⅱ型动脉瘤。血管造影显示动脉瘤有活动性造影剂外渗。使用一个5厘米长、6毫米宽的血管内移植物对动脉瘤进行了封堵。6个月后，双功超声检查显示血管内移植物通畅，肾实质下极和中极灌注正常，肾小球滤过率为75毫升/分钟。
对于部分选定患者，使用血管内移植物进行血管内封堵可能为治疗破裂性肾动脉动脉瘤提供一种安全、快速的手术替代方法。
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