Hayashi Jun, Uchida Tetsuro, Hamasaki Azumi, Yamashita Atsushi, Nakamura Ken, Kobayashi Kimihiro, Sadahiro Mitsuaki
Division of Cardiovascular Surgery, Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Yamagata, Japan.
Ann Thorac Cardiovasc Surg. 2019 Apr 20;25(2):120-122. doi: 10.5761/atcs.cr.17-00212. Epub 2018 Feb 16.
An 84-year-old man with chronic obstructive pulmonary disease (COPD) was referred to our institution for further treatment of severe swelling of the left lower extremity. The left iliac vein was compressed by the abdominal aortic aneurysm and a right common iliac arterial aneurysm measuring 62 mm and 45 mm in diameter and was partially thrombosed. Multiple pulmonary artery embolisms were also noted. Endovascular repair of the abdominal aortic aneurysm and the right common iliac arterial aneurysm was performed because of his respiratory dysfunction. The left leg edema gradually resolved after endovascular treatment. Six months after the treatment, computed tomography (CT) demonstrated resolution of the venous thrombus of the left lower extremity. Although open surgery is reliable treatment for iliac compression syndrome, endovascular treatment might be a feasible and an adequate therapeutic option for patients who have severe comorbidities, complications, or high frailties.
一名患有慢性阻塞性肺疾病(COPD)的84岁男性因左下肢严重肿胀被转诊至我院接受进一步治疗。左髂静脉被直径分别为62毫米和45毫米的腹主动脉瘤及右髂总动脉瘤压迫,且部分血栓形成。还发现了多发性肺动脉栓塞。由于其呼吸功能障碍,对腹主动脉瘤和右髂总动脉瘤进行了血管内修复。血管内治疗后左腿水肿逐渐消退。治疗六个月后,计算机断层扫描(CT)显示左下肢静脉血栓消失。虽然开放手术是治疗髂静脉压迫综合征的可靠方法,但对于有严重合并症、并发症或高度虚弱的患者,血管内治疗可能是一种可行且合适的治疗选择。