破裂腹主动脉瘤急诊开放修复术后Ⅱ型内漏的非典型表现
Atypical Presentation of a Type 2 Endoleak following Emergency Open Repair of a Ruptured Abdominal Aortic Aneurysm.
作者信息
Sharma K, Halandras P, Milner R
机构信息
Central Michigan University College of Medicine, Mount Pleasant, MI, USA.
Division of Vascular Surgery and Endovascular Therapy, Loyola University Medical Center, Maywood, IL, USA.
出版信息
EJVES Short Rep. 2016 Oct 10;33:24-26. doi: 10.1016/j.ejvssr.2016.09.002. eCollection 2016.
BACKGROUND
An endoleak is a common complication following EVAR. Specifically, a Type 2 endoleak occurs because of retrograde flow from lumbar vessels outside the endograft within the aneurysm sac. Even though it is common following EVAR, it has not been identified as a complication following open ruptured abdominal aortic aneurysm (AAA) repair.
REPORT
A 73-year-old male underwent open repair of a ruptured AAA. Five months later, computed tomography revealed filling from a lumbar vessel mimicking a Type 2 "endoleak." The initial ultrasound showed a single pair of lumbar vessels with aneurysm sac expansion 8 weeks later. The "endoleak" and expanding sac were treated, and the 2-year surveillance demonstrated sac shrinkage.
DISCUSSION
Because endoleak is a complication after EVAR, this case provides a unique presentation of Type 2 "endoleak" physiology following open repair of a ruptured AAA. It is believed that it is necessary to expand the list of possible complications after open ruptured AAA repair to include "endoleaks."
背景
内漏是腔内修复腹主动脉瘤（EVAR）术后常见的并发症。具体而言，Ⅱ型内漏是由于动脉瘤腔内移植物外的腰动脉出现逆向血流所致。尽管其在EVAR术后很常见，但在开放性破裂腹主动脉瘤（AAA）修复术后尚未被认定为一种并发症。
报告
一名73岁男性接受了开放性破裂AAA修复术。五个月后，计算机断层扫描显示来自腰动脉的充盈，类似Ⅱ型“内漏”。最初的超声检查显示8周后有一对腰动脉伴有动脉瘤腔扩张。对“内漏”和扩张的瘤腔进行了治疗，两年的随访显示瘤腔缩小。
讨论
由于内漏是EVAR术后的并发症，该病例呈现了开放性破裂AAA修复术后Ⅱ型“内漏”生理学的独特表现。据信有必要扩大开放性破裂AAA修复术后可能并发症的范围，将“内漏”包括在内。
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