Bae Esther, Vo Trung Duong
Department of General Surgery, Arrowhead Regional and Kaiser Permanente Fontana Medical Centers, Fontana, CA.
Department of General and Vascular Surgery, Kaiser Permanente Fontana, CA.
Ann Vasc Surg. 2017 Jul;42:62.e1-62.e4. doi: 10.1016/j.avsg.2016.10.050. Epub 2017 Mar 8.
Large celiac artery aneurysms are associated with a high rupture and mortality risk. Traditionally, open surgical repair has been the mainstay of treatment. Endovascular alternatives have been increasingly described, ranging from coil embolization to exclusion with covered stent grafts. Certain features such as a short wide neck, small vessel diameters, and severe vessel tortuosity can limit these two options. We describe a 75-year-old man with a splenic and celiac trunk aneurysm that was treated using a combination of coil embolization to occlude the outflow artery and aneurysm sac, followed by an aortic stent graft cuff to block the inflow. This resulted in successful exclusion of the splenic and celiac artery aneurysms while preserving flow to both the spleen and liver through collateral pathways.
大型腹腔干动脉瘤破裂风险和死亡率较高。传统上,开放手术修复一直是主要的治疗方法。血管内治疗方案的描述越来越多,从弹簧圈栓塞到覆膜支架移植物置入术。某些特征,如短而宽的瘤颈、小血管直径和严重的血管迂曲,可能会限制这两种治疗选择。我们描述了一名75岁男性,患有脾动脉瘤和腹腔干动脉瘤,采用弹簧圈栓塞闭塞流出动脉和瘤囊,随后使用主动脉支架移植物袖套阻断流入动脉的联合治疗方法。这成功地排除了脾动脉瘤和腹腔干动脉瘤,同时通过侧支循环保留了脾脏和肝脏的血流。