Leszczyński Jerzy, Macioch Waldemar, Chudziński Witold, Gałązka Zbigniew
Department of General and Endocrine Surgery, Medical University of Warsaw, Warsaw, Poland.
Wideochir Inne Tech Maloinwazyjne. 2017 Sep;12(3):320-324. doi: 10.5114/wiitm.2017.69239. Epub 2017 Jul 31.
Thoracic endovascular aortic repair (TEVAR) effectively improved the results of thoracic aortic aneurysm treatment. TEVAR is a less invasive procedure that can be performed under local anesthesia with shorter hospital stay. The perioperative morbidity and mortality rates are lower for endovascular than open repair, but the rate of secondary interventions is higher for TEVAR. We report a case of an elderly man with synchronous abdominal and thoracic aortic aneurysms. A type III dangerous endoleak was recognized 3 years after TEVAR. It was successfully repaired during an endovascular procedure. There were no new endoleaks after 12 months of follow-up. TEVAR may be the only option of treatment for risky and elderly patients. However, postoperative monitoring is necessary to exclude different types of endoleaks. Most of them undergo effective endovascular repair.
胸主动脉腔内修复术(TEVAR)有效改善了胸主动脉瘤的治疗效果。TEVAR是一种侵入性较小的手术,可在局部麻醉下进行,住院时间较短。血管腔内修复术的围手术期发病率和死亡率低于开放修复术,但TEVAR的二次干预率较高。我们报告一例老年男性同时患有腹主动脉瘤和胸主动脉瘤的病例。TEVAR术后3年发现III型危险内漏。在一次血管腔内手术中成功修复。随访12个月后未出现新的内漏。TEVAR可能是高危和老年患者唯一的治疗选择。然而,术后监测对于排除不同类型的内漏是必要的。大多数内漏可通过有效的血管腔内修复术进行治疗。