Duvnjak Stevo
Department of Radiology, Odense University Hospital, Odense, Denmark.
Int J Angiol. 2016 Dec;25(5):e111-e114. doi: 10.1055/s-0034-1544126. Epub 2015 Jan 28.
Endovascular aortic repair (EVAR) has become preferable treatment of abdominal aortic aneurysms because of proven mortality reduction as well as complications reduction compared with open surgery. Endoleak remains a primary complication of EVAR, however, and occurs in 20 to 25% of the patients. EVAR patients thus undergo lifelong surveillance for the presence of aneurysm expansion and endoleaks usually via computed tomographic angiography. We describe the endovascular management of an enlarged aneurysmal sac size 3 years after EVAR due to combined endoleak of types 1 and 3. We needed to use a fenestrated aortic cuff, a main body graft extension, and an aortouniiliac converter device to seal the leak. This case highlights the potential challenges in identifying and treating type III endoleaks.
与开放手术相比，血管内主动脉修复术（EVAR）已成为腹主动脉瘤的首选治疗方法，因为它已被证明可降低死亡率并减少并发症。然而，内漏仍然是EVAR的主要并发症，发生率为20%至25%。因此，接受EVAR治疗的患者通常通过计算机断层血管造影术进行终身监测，以检查是否存在动脉瘤扩张和内漏。我们描述了1型和3型内漏合并导致EVAR术后3年动脉瘤囊扩大的血管内治疗方法。我们需要使用带开窗的主动脉袖套、主体移植物延长段和主动脉单髂动脉转换装置来封闭漏口。该病例突出了识别和治疗III型内漏的潜在挑战。
