Wu Wei-Wei, Lin Chen, Liu Bao, Liu Chang-Wei
Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
Chin Med J (Engl). 2015 Mar 5;128(5):674-9. doi: 10.4103/0366-6999.151674.
To evaluate the feasibility of a new surgeon-modified iliac branch device (IBD) technique to maintain pelvic perfusion in the management of common iliac artery (CIA) aneurysm during endovascular aneurysm repair (EVAR).
From January 2011 to December 2013, a new surgeon-modified IBD technique was performed in department of vascular surgery of Peking Union Medical College Hospital in five patients treated for CIA aneurysm with or without abdominal aortic aneurysm. A stent-graft limb was initially deployed in vitro, anastomosed with vascular graft, creating a modified IBD reloaded into a larger sheath, with or without a guidewire preloaded into the side branch. The reloaded IBD was then placed in the iliac artery, with a covered stent bridging internal iliac artery and the branch. Finally, a bifurcated stent-graft was deployed, and a limb device was used to connect the main body and IBD.
Technical successes were obtained in all patients. The mean follow-up length was 24 months (range: 6-38 months). All grafts remained patent without any sign of endoleaks. There were no aneurysm ruptures, deaths, or other complications related to pelvic flow.
Using the surgeon-modified IBD to preserve pelvic flow is a feasible endovascular technique and an appealing solution for personalized treatment of CIA aneurysm during EVAR.
评估一种新的外科医生改良髂支装置（IBD）技术在血管腔内修复术（EVAR）治疗髂总动脉（CIA）动脉瘤过程中维持盆腔灌注的可行性。
2011年1月至2013年12月，北京协和医院血管外科对5例患有或不患有腹主动脉瘤的CIA动脉瘤患者采用了一种新的外科医生改良IBD技术。首先在体外展开一个覆膜支架移植物肢体，与血管移植物吻合，制作一个改良的IBD并重新装入更大的鞘管中，侧支内可预装入或不预装入导丝。然后将重新装入的IBD置入髂动脉，用一个覆膜支架连接髂内动脉和分支。最后，展开一个分叉覆膜支架移植物，并用一个肢体装置连接主体和IBD。
所有患者技术成功。平均随访时间为24个月（范围：6 - 38个月）。所有移植物均保持通畅，无任何内漏迹象。无动脉瘤破裂、死亡或与盆腔血流相关的其他并发症。
使用外科医生改良的IBD来保留盆腔血流是一种可行的血管腔内技术，是EVAR治疗CIA动脉瘤个性化治疗的一个有吸引力的解决方案。
