Yoshitake Akihiro, Hachiya Takashi, Itoh Takahito, Kitahara Hiroto, Kasai Mio, Kawaguchi Shinji, Shimizu Hideyuki
Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
Ann Vasc Surg. 2015 Apr;29(3):595.e15-7. doi: 10.1016/j.avsg.2014.10.039. Epub 2015 Jan 14.
Here, we describe a case of nonvisualized type III endoleak masquerading as endotension that was diagnosed by opening the aneurysm sac during surgery and successfully treated surgically. A 79-year-old man underwent endovascular aneurysm repair (EVAR) 4 years previously for an aneurysm that had enlarged gradually without endoleak. An open surgical operation was performed. The sac pressure was 132 mm Hg-similar to the preoperative systolic blood pressure-and nonpulsatile. After the aneurysm sac was opened without clamping the aorta, a type III endoleak from the suture point of the prosthetic endograft was detected. The prosthetic graft was successfully replaced with a Y-graft. The current findings suggest that nonvisualized type III endoleaks may be a potential cause of endotension.
在此，我们描述一例伪装为内张力的隐匿性Ⅲ型内漏病例，该病例在手术中通过打开动脉瘤囊得以诊断，并经手术成功治疗。一名79岁男性4年前因动脉瘤逐渐增大且无内漏接受了血管内动脉瘤修复术（EVAR）。随后进行了开放手术。囊内压力为132 mmHg，与术前收缩压相似且无搏动。在未夹闭主动脉的情况下打开动脉瘤囊后，检测到人工血管内支架移植物缝合点处存在Ⅲ型内漏。成功地用Y型移植物替换了人工血管移植物。目前的研究结果表明，隐匿性Ⅲ型内漏可能是内张力的一个潜在原因。
