Dutu Bogdan, Zdrenghea Dumitru, Pop Dana, Cismaru Gabriel, Martis Alexandru, Iancu Adrian C
Cardiology Clinic, "Spitalul Clinic De Recuperare", Cluj Napoca, Romania.
Cardiology Clinic, "Institutul Inimii Niculae Stancioiu", Cluj Napoca, Romania.
Am J Case Rep. 2018 May 22;19:589-592. doi: 10.12659/AJCR.907547.
BACKGROUND Aortic occlusion, whether acute or subacute, is a rare but very serious entity with disastrous consequences if not treated in a timely fashion. Rapid diagnosis is crucial in this setting. In surgically treated patients there is a high degree of mortality and morbidity; therefore, percutaneous revascularization, whenever possible and independent of the available techniques, is much more desirable. CASE REPORT A 62-year-old woman with a history of diabetes mellitus, dyslipidemia, hypertension, and peripheral vascular disease, with previous femoral-femoral bypass for right common iliac artery occlusion, and with recent conventional angiography showing near occlusion of the ostial left common iliac artery (the donor vessel for the previous bypass), was referred to our hospital for conventional angioplasty. We faced were surprised to find a total infrarenal aortic occlusion and decided to perform emergency and rescue recanalization. We successfully recanalized the aorta and left iliac artery by stent implantation and stabilized the patient, considering that surgical intervention has very high risk for morbidity and mortality in this particular setting. CONCLUSIONS Although revascularization is rarely performed in this life-threating condition, endovascular recanalization of a subacute aortic occlusion in a patient with femoral-femoral bypass is feasible and can be life-saving.
主动脉闭塞,无论是急性还是亚急性,都是一种罕见但非常严重的病症,如果不及时治疗会产生灾难性后果。在这种情况下,快速诊断至关重要。在接受手术治疗的患者中,死亡率和发病率都很高;因此,只要有可能且不考虑现有技术,经皮血管重建术更为可取。病例报告:一名62岁女性,有糖尿病、血脂异常、高血压和周围血管疾病史,既往因右髂总动脉闭塞行股-股旁路移植术,近期传统血管造影显示左髂总动脉开口处近乎闭塞(先前旁路移植术的供体血管),因传统血管成形术转诊至我院。我们惊讶地发现是完全性肾下腹主动脉闭塞,决定进行紧急抢救性再通术。考虑到在这种特殊情况下手术干预的发病率和死亡率非常高,我们通过支架植入成功地使主动脉和左髂动脉再通并使患者病情稳定。结论:尽管在这种危及生命的情况下很少进行血管重建术,但对于有股-股旁路移植术的患者,亚急性主动脉闭塞的血管腔内再通术是可行的,且可挽救生命。