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[主动脉支架移位:血管腔内修复术后的罕见并发症]

[Aortic stent migration: a rare complication after endovascular repair].

作者信息

Kaouel K, Ben Hammamia M, Ben Mrad M, Laaribi J, Ben Omrane S, Elleuch N, Denguir R, Kalfat T, Khayati A

机构信息

Service de chirurgie cardiovasculaire et thoracique La Rabta, Tunis, Tunisie; Faculté de médecine de Tunis, université de Tunis, El Manar, Tunisie.

Service de chirurgie cardiovasculaire et thoracique La Rabta, Tunis, Tunisie; Faculté de médecine de Tunis, université de Tunis, El Manar, Tunisie.

出版信息

J Mal Vasc. 2014 May;39(3):216-9. doi: 10.1016/j.jmv.2014.03.002. Epub 2014 Apr 6.

Abstract

Migration of an aortic stent is one of the most serious complications that can occur during follow-up after endovascular repair of an abdominal aortic aneurysm. We report the case of a 75-year-old man who underwent endovascular treatment for an infra-renal aortic aneurysm using an aorto-mono-iliac stent associated to a femoro-femoral bypass. The angiography performed at the end of procedure showed complete exclusion of the aneurysm. The postoperative course was uneventful. CT scans at 1, 6 and 12 months were normal. The CT scan at the 18th month showed a proximal migration of the stent, which was complicated by a type 1 endoleak and a stent disjunction with a type 3 endoleak. Revision surgery was indicated but the patient died from aneurismal rupture pending treatment. The migration of an aortic stent is a rare but serious complication of endovascular aneurysmal repair. Prevention requires a precise anatomical selection and adequate deployment of the stent graft.

摘要

主动脉支架移位是腹主动脉瘤血管腔内修复术后随访期间可能发生的最严重并发症之一。我们报告一例75岁男性患者,该患者接受了使用主动脉单髂动脉支架联合股-股旁路术对肾下主动脉瘤进行血管腔内治疗。手术结束时进行的血管造影显示动脉瘤完全被隔绝。术后过程顺利。术后1个月、6个月和12个月的CT扫描均正常。第18个月的CT扫描显示支架近端移位,并发1型内漏和支架分离伴3型内漏。虽已建议进行翻修手术,但患者在等待治疗期间死于动脉瘤破裂。主动脉支架移位是血管腔内动脉瘤修复术罕见但严重的并发症。预防需要精确的解剖学选择和支架移植物的充分展开。

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