Kotsis Thomas, Louizos Louizos Alexander, Pappas Evangelos, Theodoraki Kassiani
Vascular Unit, 2nd Clinic of Surgery, School of Medicine, University of Athens, Aretaieion Hospital, Vas. Sophias 76, 115 28 Athens, Greece.
1st Department of Anesthesiology, School of Medicine, University of Athens, Aretaieion Hospital, Vas. Sophias 76, 115 28 Athens, Greece.
Int J Vasc Med. 2014;2014:178610. doi: 10.1155/2014/178610. Epub 2014 Sep 28.
Objective. Bilateral internal iliac artery aneurysms constitute the utmost configuration of infrarenal aortoiliac disease. We detail characteristic aortoiliac disease patterns and reconstructive techniques we have used, along with a visualized decision-making chart and a short review of the literature. Material and Methods. A retrospective, observational study of twelve clinical cases of patients with aortoiliac disease are described. Two patients had a common iliac artery aneurysm and were managed by the application of inversed stent-grafts; another case was repaired by the insertion of a standard bifurcated stent-graft flared in the right common iliac artery and with an iliac branched device in the left iliac arterial axis. Open approach was used in 5 cases and in 4 cases a combination of aortouniliac stent-grafting with femoral-femoral bypass was applied. Results. Technical success was 100%. One endoleak type Ib in a flared iliac limb was observed and corrected by internal iliac embolism and use of an iliac limb stent-graft extension. We report 100% patency rate during 26.3 months of followup. Conclusion. Individualized techniques for the management of isolated iliac or aortoiliac aneurismal desease with special concern in maintaining internal iliac artery perfusion lead to elimination of perioperative complications and long-term durability and patency rates.
目的。双侧髂内动脉瘤是肾下腹主动脉髂动脉疾病的最严重形式。我们详细介绍了我们所采用的特征性腹主动脉髂动脉疾病模式和重建技术，以及一个可视化的决策图表和文献综述。材料与方法。描述了一项对12例腹主动脉髂动脉疾病患者的回顾性观察研究。2例患者患有髂总动脉瘤，采用倒置覆膜支架治疗；另一例通过在右髂总动脉置入标准分叉覆膜支架并在左髂动脉轴置入髂支装置进行修复。5例采用开放手术，4例采用腹主动脉单髂动脉覆膜支架置入术联合股-股旁路术。结果。技术成功率为100%。观察到一例髂支扩张处的Ib型内漏，通过髂内动脉栓塞和使用髂支覆膜支架延长段进行了纠正。我们报告在26.3个月的随访期间通畅率为100%。结论。个体化技术用于治疗孤立性髂动脉或腹主动脉髂动脉动脉瘤疾病，特别关注维持髂内动脉灌注，可消除围手术期并发症，并具有长期耐久性和通畅率。
