一名患有埃勒斯-当洛综合征的患者，因髂总动脉瘤穿孔继发髂动静脉瘘的血管内修复术。
Endovascular repair of an iliac arteriovenous fistula secondary to perforation from a common iliac aneurysm in a patient with Ehler-Danlos syndrome.
作者信息
Sala Almonacil Vicente Andrés, Zaragozá García José Miguel, Gómez Palonés Francisco Julián, Plaza Martínez Ángel, Ortíz Monzón Eduardo
机构信息
Department of Angiology, Vascular and Endovascular Surgery, Hospital Universitario Doctor Peset, Valencia, Spain.
出版信息
Ann Vasc Surg. 2012 Aug;26(6):861.e11-5. doi: 10.1016/j.avsg.2012.01.016.
BACKGROUND
Type IV Ehler-Danlos syndrome (EDS) patients are prone to life-threatening vascular complications. Surgical management of those complications is challenging owing to vessel wall fragility, which may result in hemorrhagic events and high mortality rates. Here we report a case of left common iliac aneurysm perforation of the ipsilateral iliac vein repaired using endovascular technique in a patient with EDS.
METHOD AND RESULTS
A 54-year-old patient presented with heart failure symptoms that evolved over 1 week in association with left leg edema and steal syndrome due to a perforation of the left iliac vein caused by a left common iliac aneurysm. A thrombosed right common iliac aneurysm and several other visceral and peripheral aneurysms were discovered on computed tomographic scan at admission. An aortouniiliac stent graft was used to seal the fistula. After 18 months of follow-up, the patient remained asymptomatic.
CONCLUSIONS
We suggest that endovascular therapy is useful to manage vascular complications in patients with EDS.
背景
IV型埃勒斯-当洛综合征（EDS）患者易发生危及生命的血管并发症。由于血管壁脆弱，这些并发症的手术治疗具有挑战性，这可能导致出血事件和高死亡率。在此，我们报告1例采用血管内技术修复同侧髂静脉左髂总动脉瘤穿孔的EDS患者。
方法与结果
一名54岁患者出现心力衰竭症状，持续1周，并伴有左腿水肿和因左髂总动脉瘤导致左髂静脉穿孔引起的窃血综合征。入院时计算机断层扫描发现右侧髂总动脉瘤血栓形成以及其他几个内脏和周围动脉瘤。使用主动脉单髂动脉支架移植物封闭瘘口。随访18个月后，患者无症状。
结论
我们认为血管内治疗对管理EDS患者的血管并发症有用。
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