Clementi Jamie, Lim Sungho, Halandras Pegge, Aulivola Bernadette, Crisostomo Paul R
Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Loyola University Chicago, Stritch School of Medicine, Maywood, IL.
Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Loyola University Chicago, Stritch School of Medicine, Maywood, IL.
Ann Vasc Surg. 2017 Nov;45:269.e1-269.e4. doi: 10.1016/j.avsg.2017.06.157. Epub 2017 Jul 21.
Iliac arterial disease, unfavorable anatomy, and prior stenting all pose challenges to access in endovascular abdominal aortic repair (EVAR) and thoracic aortic repair (TEVAR). Iliac access injury during T/EVAR may lead to rupture, dissection, thrombosis, or distal ischemia. Some have advocated iliac stent prior to T/EVAR in patients with suboptimal iliac access. The rate of complication and iliac stent migration during subsequent T/EVAR is undocumented. This case report describes a unique instance of self-expanding iliac stent migration during TEVAR which pinched the thoracic aortic endograft causing functional aortic coarctation.
髂动脉疾病、解剖结构不佳以及既往支架置入都对血管腔内腹主动脉修复术（EVAR）和胸主动脉修复术（TEVAR）的入路构成挑战。在TEVAR或EVAR期间，髂动脉入路损伤可能导致破裂、夹层、血栓形成或远端缺血。对于髂动脉入路欠佳的患者，一些人主张在TEVAR或EVAR之前置入髂动脉支架。后续TEVAR期间的并发症发生率和髂动脉支架移位情况尚无记录。本病例报告描述了TEVAR期间自膨式髂动脉支架移位的一个独特实例，该移位压迫了胸主动脉内移植物，导致功能性主动脉缩窄。
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