Ahmad Wael, Gawenda Michael, Brunkwall Silke, Shahverdyan Robert, Brunkwall Jan Sigge
Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany.
Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany.
Ann Vasc Surg. 2016 May;33:231.e5-9. doi: 10.1016/j.avsg.2015.11.031. Epub 2016 Mar 8.
The endovascular aneurysm repair (EVAR) is becoming the preferred method to treat an aortic aneurysm with its better short-term postoperative mortality and morbidity rates in comparison with the open repair. A main drawback of this method is the need to use a nephrotoxic iodinated contrast medium to visualize the aorta and its side branches.
An 83-year-old man with an asymptomatic infrarenal aortic aneurysm of a 51-mm diameter accompanied by a 42-mm aneurysm of the left common iliac artery was treated with combined fenestrated EVAR (FEVAR) and iliac side branch stent graft (ISBG) under guidance of image fusion (IF) without the intraoperative use of iodinated contrast agent.
Complex EVAR (FEVAR and ISBG) using computed tomography angiography IF is feasible and together with the use of CO2 angiography may help to abstain from need to nephrotoxic contrast medium.
与开放修复相比，血管内动脉瘤修复术（EVAR）因其术后短期死亡率和发病率较低，正成为治疗主动脉瘤的首选方法。该方法的一个主要缺点是需要使用肾毒性碘化造影剂来显示主动脉及其分支。
一名83岁男性，患有直径51mm的无症状肾下腹主动脉瘤，伴有左髂总动脉瘤，直径42mm，在图像融合（IF）引导下，采用开窗式EVAR（FEVAR）和髂侧支支架移植物（ISBG）联合治疗，术中未使用碘化造影剂。
使用计算机断层扫描血管造影IF的复杂EVAR（FEVAR和ISBG）是可行的，并且与二氧化碳血管造影一起使用可能有助于避免使用肾毒性造影剂。
