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腹腔干动脉瘤的腔内隔绝术联合弹簧圈栓塞术

Endograft-assisted coil embolization of a celiac trunk aneurysm.

作者信息

Plaza-Martínez Ángel, Genovés-Gascó Beatriz, Cester-Ves Diana, Gómez-Palonés Francisco J

机构信息

Hospital Universitario Dr. Peset and Hospital NISA 9 de Octubre, Valencia, Spain.

Hospital Universitario Dr. Peset and Hospital NISA 9 de Octubre, Valencia, Spain.

出版信息

Ann Vasc Surg. 2014 Jan;28(1):263.e1-5. doi: 10.1016/j.avsg.2013.02.022. Epub 2013 Sep 29.

Abstract

BACKGROUND

Celiac trunk aneurysms are rare but potential life-threatening lesions. Endovascular techniques are more often used for their treatment because of low rates of morbidity and mortality.

CASE REPORT

We describe a modification of stent-assisted coil embolization technique more commonly used in the treatment of intracranial aneurysm, to exclude a 50-mm diameter celiac trunk aneurysm. The patient was a 67-year-old man who had a previous exclusion of a symptomatic aortic aneurysm, with occlusion of the inferior mesenteric and both hypogastric arteries. Anatomic features of the celiac trunk aneurysm and its branches do not allow treatment with a straight endograft or maintain direct flow to the hepatic artery. We then performed an endograft-assisted coil embolization of the aneurysm, with a straight flow line to the splenic artery.

CONCLUSION

Endograft-assisted coil embolization is a feasible and safe technique to allow selective embolization of the sac and the presence of direct flow to the splenic artery and indirect flow to the hepatic artery.

摘要

背景

腹腔干动脉瘤罕见,但有潜在生命危险。由于发病率和死亡率较低,血管内技术更常用于其治疗。

病例报告

我们描述了一种对颅内动脉瘤治疗中更常用的支架辅助弹簧圈栓塞技术的改良方法,用于排除一个直径50毫米的腹腔干动脉瘤。患者为一名67岁男性,既往有症状性主动脉瘤被排除,肠系膜下动脉和双侧髂内动脉闭塞。腹腔干动脉瘤及其分支的解剖特征不允许使用直管型血管内移植物进行治疗,也无法维持对肝动脉的直接血流。然后,我们对动脉瘤进行了血管内移植物辅助弹簧圈栓塞,建立了一条通向脾动脉的直线血流通道。

结论

血管内移植物辅助弹簧圈栓塞是一种可行且安全的技术,可实现瘤腔的选择性栓塞,并使脾动脉有直接血流、肝动脉有间接血流。

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