Takebayashi Satoshi, Hirota Jun, Mori Kazuki, Shuto Takashi, Okamoto Keitaro, Sato Aiko, Wada Tomoyuki, Anai Hirofumi, Miyamoto Shinji
Department of Cardiovascular Surgery, Oita University, Yufu, Oita, Japan.
Department of Medical Engineering, Oita University, Yufu, Oita, Japan.
Ann Vasc Dis. 2016;9(2):120-4. doi: 10.3400/avd.cr.16-00012. Epub 2016 Apr 25.
Endovascular aortic aneurysm repair (EVAR) has revolutionized the management of abdominal aortic aneurysms (AAAs), with lower perioperative morbidity and mortality compared to conventional surgical repair. However, late secondary re-interventions after EVAR are still needed before aneurysm rupture in many cases. A patient with impending rupture of an AAA associated with a type I endoleak 7 years after EVAR who was successfully treated with a unique technique of fixation of the proximal aortic neck taking into account the structure of the stent graft is reported. This technique offers a safe solution to late open conversion after failed EVAR.
血管内主动脉瘤修复术（EVAR）彻底改变了腹主动脉瘤（AAA）的治疗方式，与传统手术修复相比，围手术期发病率和死亡率更低。然而，在许多情况下，EVAR术后仍需要在动脉瘤破裂前进行晚期二次干预。本文报道了1例EVAR术后7年发生AAA破裂且伴有I型内漏的患者，该患者通过一种考虑到覆膜支架结构的独特近端主动脉颈部固定技术成功治愈。该技术为EVAR失败后的晚期开放转换提供了一种安全的解决方案。
