使用市售分支型腔内移植物挽救失败的肾下主动脉腔内修复术
Rescue of a Failing Endovascular Infrarenal Aortic Repair Using an Off-The-Shelf Branched Endograft.
作者信息
Gemayel Gino, Verdon Gabriel, Murith Nicolas, Huber Christoph
机构信息
Cardiovascular Surgery Department, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Cardiovascular Surgery Department, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
出版信息
Ann Vasc Surg. 2017 Nov;45:269.e15-269.e18. doi: 10.1016/j.avsg.2017.07.016. Epub 2017 Jul 21.
BACKGROUND
Proximal aortic dilation following open and endovascular aortic repair (EVAR) is a well-known phenomenon. If severe enough, it may lead to late onset of type Ia endoleak that jeopardizes the proximal seal.
METHODS
We report the case of a patient previously treated by EVAR for an infrarenal aneurysm who developed a type Ia endoleak after proximal aortic dilation. His aneurysms enlarged to 10 cm mandating a rapid repair without the delay for a custom-made device.
RESULTS
We successfully used the off-the-shelf thoracic t-Branch graft (Cook, Bloomington, IN) with its 4 branches to treat the dilated aorta and seal the endoleak.
CONCLUSION
The off-the-shelf t-Branch is a useful option in patient with previous EVAR presenting with proximal aortic dilation and endoleak who cannot wait for a custom-made device.
背景
开放及血管腔内主动脉修复术（EVAR）后近端主动脉扩张是一种众所周知的现象。如果严重到一定程度，可能会导致Ia型内漏的晚期发生，从而危及近端密封。
方法
我们报告了一例曾接受EVAR治疗肾下动脉瘤的患者，该患者在近端主动脉扩张后出现Ia型内漏。其动脉瘤增大至10厘米，需要迅速修复，不能等待定制装置。
结果
我们成功使用了现成的带4个分支的胸段t型分支移植物（库克公司，印第安纳州布卢明顿）来治疗扩张的主动脉并封闭内漏。
结论
对于先前接受过EVAR治疗、出现近端主动脉扩张和内漏且无法等待定制装置的患者，现成的t型分支移植物是一种有用的选择。
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