Malkawi Amir H, de Bruin Jorg L, Loftus Ian M, Thompson Matt M
St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK.
J Endovasc Ther. 2014 Aug;21(4):538-40. doi: 10.1583/14-4698R.1.
To present treatment of a juxtarenal aneurysm using the Nellix endovascular aneurysm sealing system (EVAS) and a chimney stent.
A 79-year-old woman was diagnosed with a 6-cm juxtarenal aneurysm. Standard endovascular aneurysm repair was not possible due to lack of an adequate infrarenal landing zone, and poor iliac access and angulated visceral aortic branches precluded a custom-made fenestrated solution. The patient was not a suitable candidate for open surgery due to significant comorbidity, so she underwent successful endovascular aneurysm repair with the Nellix EVAS system and a renal chimney stent. Follow-up imaging at 6 months showed a sealed aneurysm sac and patent renal chimney stent.
The Nellix EVAS system obliterates the aneurysm sac using polymer-filled endobags. The ability of the endobags to conform to adjacent structures may offer advantages over conventional endografts when combined with parallel grafts designed to treat juxtarenal aneurysms.
介绍使用Nellix血管内动脉瘤封闭系统(EVAS)和烟囱式支架治疗肾旁动脉瘤的方法。
一名79岁女性被诊断出患有一个6厘米的肾旁动脉瘤。由于缺乏足够的肾下锚定区,标准的血管内动脉瘤修复术无法进行,且髂动脉入路不佳和内脏主动脉分支成角排除了定制开窗解决方案。由于严重的合并症,该患者不适合进行开放手术,因此她使用Nellix EVAS系统和肾烟囱式支架成功进行了血管内动脉瘤修复术。6个月后的随访成像显示动脉瘤囊被封闭,肾烟囱式支架通畅。
Nellix EVAS系统使用填充聚合物的内袋闭塞动脉瘤囊。当与设计用于治疗肾旁动脉瘤的平行移植物结合使用时,内袋与相邻结构贴合的能力可能比传统的血管内移植物具有优势。