Pfister K, Kasprzak P M, Apfelbeck H, Kopp R, Janotta M, Schierling W
Division of Vascular Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany.
EJVES Short Rep. 2016 Mar 12;31:1-5. doi: 10.1016/j.ejvssr.2016.02.004. eCollection 2016.
OBJECTIVE/BACKGROUND: To report on our experience of the treatment of aortic aneurysms by custom-made, branched stent-grafts with an additional inferior mesenteric artery (IMA) side branch to preserve IMA perfusion in patients at risk for colon ischemia.
Three male patients (mean age 60 years) with a thoracoabdominal, pararenal, and infrarenal aortic aneurysm (AA), respectively, were treated by endovascular aneurysm exclusion using custom-made, branched stent-grafts with a side branch to the IMA for prevention of colon ischemia. Indications for selective IMA side branch perfusion were occlusions or high-grade stenosis of the visceral or hypogastric arteries.
No colon ischemia and no neurological deficit were observed. All three IMA side branches were perfused and patent, as documented by computed tomography scan and duplex ultrasound postoperatively and after 12 months. Patency after 24 months was documented as 2/3.
Custom-made, branched stent-grafts are an endovascular option to preserve the IMA perfusion in selected, electively treated patients with an increased risk for insufficient colon perfusion due to stenosis or occlusions of visceral or hypogastric arteries.
目的/背景：报告我们使用定制的分支型覆膜支架治疗主动脉瘤的经验，该支架带有额外的肠系膜下动脉（IMA）侧支，以在有结肠缺血风险的患者中保留IMA灌注。
分别对3例男性患者（平均年龄60岁）进行治疗，他们分别患有胸腹主动脉瘤、肾旁主动脉瘤和肾下主动脉瘤（AA），采用定制的带有IMA侧支的分支型覆膜支架进行血管内动脉瘤隔绝术，以预防结肠缺血。选择性IMA侧支灌注的指征是内脏动脉或腹下动脉闭塞或高度狭窄。
未观察到结肠缺血和神经功能缺损。术后及12个月后通过计算机断层扫描和双功超声检查记录，所有3个IMA侧支均有灌注且通畅。24个月后的通畅率记录为2/3。
对于因内脏动脉或腹下动脉狭窄或闭塞而导致结肠灌注不足风险增加的特定择期治疗患者，定制的分支型覆膜支架是一种保留IMA灌注的血管内治疗选择。
