一名因下腔静脉血栓形成而出现下肢水肿的患者的大型腹主动脉瘤的血管内修复术。
Endovascular Repair of a Large Abdominal Aortic Aneurysm in a Patient Presenting with Lower Extremity Edema as a Result of Inferior Vena Cava Thrombosis.
作者信息
Li Nan, Xue Ming, Hong Deng-Ke, Chen Xing-Sheng
机构信息
Department of Vascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
Department of Vascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
出版信息
Ann Vasc Surg. 2017 Jul;42:300.e11-300.e14. doi: 10.1016/j.avsg.2016.11.018. Epub 2017 Mar 22.
PURPOSE
Abdominal aortic aneurysm (AAA) can present with symptoms because of aneurysmal compression of adjacent organ systems. This condition has always been treated by open surgical repair. Here, we report a case of an AAA complicated by inferior vena cava (IVC) thrombosis and deep venous thrombosis (DVT) due to IVC compression by aneurysm successfully treated by endovascular aneurysm repair (EVAR).
CASE REPORT
A 50-year-old man was presented with 3-day right lower extremity edema. He was diagnosed with acute DVT and IVC thrombosis initially. Anticoagulation therapy and catheter-directed thrombolysis under the protection of IVC filter were performed. Subsequent imaging revealed a 9.5-cm infrarenal AAA compressing the IVC. The patient was transferred to our hospital and underwent EVAR successfully.
CONCLUSIONS
EVAR is a viable treatment option for patients with an AAA complicated by IVC thrombosis and DVT due to IVC compression by aneurysm.
目的
腹主动脉瘤（AAA）可因瘤体压迫相邻器官系统而出现症状。这种情况一直通过开放手术修复进行治疗。在此，我们报告一例腹主动脉瘤合并下腔静脉（IVC）血栓形成及因动脉瘤压迫下腔静脉导致的深静脉血栓形成（DVT），经血管腔内动脉瘤修复术（EVAR）成功治疗的病例。
病例报告
一名50岁男性出现右下肢水肿3天。最初诊断为急性DVT和IVC血栓形成。在IVC滤器保护下进行了抗凝治疗和导管定向溶栓。随后的影像学检查显示一个9.5厘米的肾下腹主动脉瘤压迫下腔静脉。患者被转至我院并成功接受了EVAR治疗。
结论
对于腹主动脉瘤合并因动脉瘤压迫下腔静脉导致IVC血栓形成和DVT的患者，EVAR是一种可行的治疗选择。
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