Hu Huanrui, Chen Xiyang, Wu Zhoupeng, Zhao Jichun, Huang Bin, Ma Yukui, Yuan Ding, Yang Yi, Xiong Fei
West China Medical School of Sichuan University, Chengdu, Sichuan Province, China.
Department of Vascular Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
Ann Vasc Surg. 2018 May;49:316.e1-316.e4. doi: 10.1016/j.avsg.2017.12.021. Epub 2018 Mar 1.
We report an aneurysm degeneration of a vein graft in a previous aortorenal bypass performed 5 years earlier for severe right renal artery stenosis due to Takayasu arteritis. The patient was a 31-year-old woman who suffered from refractory hypertension. The autogenous bypass adopting great saphenous vein was performed from her infrarenal abdominal aorta to her right renal artery. Five years after the operation, the patient complained vague discomfort in her abdomen. Three-dimensional computed tomography angiography reconstruction demonstrated the existence of an aneurysm with a maximum diameter of 1.5 cm at the distal portion of a previous aortorenal vein graft, and >75% stenosis of the right renal artery. The replacement of a previous vein graft bypass with autograft or artificial graft is reported in literature. In this case, we attempted endovascular procedures by embolization of the aneurysm and revascularization of the right renal artery using coils and Viabahn stents.
我们报告了一例5年前因高安动脉炎导致严重右肾动脉狭窄而行主动脉-肾动脉搭桥术的静脉移植物动脉瘤样变性病例。患者为一名31岁患有难治性高血压的女性。采用大隐静脉进行自体搭桥，从其肾下腹主动脉至右肾动脉。术后5年，患者诉腹部有模糊不适感。三维计算机断层扫描血管造影重建显示，在先前主动脉-肾动脉静脉移植物的远端存在一个最大直径为1.5厘米的动脉瘤，且右肾动脉狭窄>75%。文献报道了用自体移植物或人工移植物替换先前静脉移植物搭桥的病例。在本病例中，我们尝试通过使用弹簧圈和Viabahn支架栓塞动脉瘤及右肾动脉血运重建的血管内手术。
