Parlani Gianbattista, Simonte Gioele, Fiorucci Beatrice, De Rango Paola, Isernia Giacomo, Fischer Matthias J, Rebonato Alberto
Unit of Vascular and Endovascular Surgery, Hospital S. Maria della Misericordia, University of Perugia, Perugia, Italy.
Unit of Vascular and Endovascular Surgery, Hospital S. Maria della Misericordia, University of Perugia, Perugia, Italy.
Ann Vasc Surg. 2016 Oct;36:293.e5-293.e10. doi: 10.1016/j.avsg.2016.03.021. Epub 2016 Jul 15.
Repair of isolated iliac aneurysm with stent-graft implantation and internal iliac coverage may induce significant type II endoleak from patent internal iliac refilling leading to ongoing aneurysm growth. Subsequent treatment of such complication can be challenging especially in case of bilateral iliac involvement. Open repair is technically demanding and often a high risk procedure, while embolization via transfemoral approach is unviable due to the stent-graft coverage precluding direct antegrade access between the common and the internal iliac lumen. Percutaneous retrograde embolization from superior gluteal artery is a feasible technique in case of impossible access through the origin of internal iliac artery.
采用覆膜支架植入术并覆盖髂内动脉来修复孤立性髂动脉瘤，可能会因髂内动脉通畅再灌注而导致严重的Ⅱ型内漏，进而致使动脉瘤持续生长。对这种并发症进行后续治疗可能具有挑战性，尤其是在双侧髂动脉受累的情况下。开放修复在技术上要求很高，且往往是高风险手术，而经股动脉途径进行栓塞不可行，因为覆膜支架的覆盖使得髂总动脉和髂内动脉管腔之间无法直接顺行进入。在无法通过髂内动脉起始部进行操作的情况下，经臀上动脉进行经皮逆行栓塞是一种可行的技术。
