Karkos Christos D, Mitka Maria, Pliatsios Ioannis, Xanthopoulou Efthalia, Giagtzidis Ioakeim T, Papadimitriou Christina T, Papazoglou Konstantinos O
5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocrateio Hospital, Thessaloniki, Greece.
5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocrateio Hospital, Thessaloniki, Greece.
Ann Vasc Surg. 2018 May;49:317.e5-317.e8. doi: 10.1016/j.avsg.2018.01.078. Epub 2018 Mar 1.
Rupture of an abdominal aortic aneurysm (AAA) after previous endovascular repair (EVAR) may require endograft explantation and replacement with a prosthetic surgical graft. Recent reports have suggested that total endograft removal during late surgical conversion in the nonruptured setting may not be necessary and that preserving functional parts of the endograft may improve results. Similar techniques may be used for ruptured cases diminishing the magnitude of an already difficult and complex procedure. We describe the successful treatment of a ruptured AAA after previous EVAR with complete endograft preservation by combining transmural endograft fixation with sutures, proximal aortic neck banding, and sac plication.
既往接受血管腔内修复术（EVAR）后发生腹主动脉瘤（AAA）破裂可能需要取出血管腔内移植物并用人工外科移植物进行置换。最近的报告表明，在未破裂情况下进行晚期手术转换时，可能无需完全取出血管腔内移植物，保留血管腔内移植物的功能部分可能会改善治疗效果。类似的技术可用于破裂病例，以减少本就困难复杂的手术的规模。我们描述了1例既往接受EVAR后发生破裂的AAA的成功治疗，通过将经壁血管腔内移植物缝合固定、近端主动脉颈绑扎和瘤囊折叠相结合，完整保留了血管腔内移植物。
