Kurç Erol, Sokullu Onur, Akansel Serdar, Sargın Murat
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey.
J Vasc Bras. 2018 Jan-Mar;17(1):66-70. doi: 10.1590/1677-5449.008017.
Despite technological advances, the long-term outcomes of endovascular aortic aneurysm repair (EVAR) are still debatable. Although most endograft failures after EVAR can be corrected with endovascular techniques, open conversion may still be required. A 70-year-old male patient presented at the emergency unit with abdominal pain. Twice, in the third and fourth years after the first repair, a stent graft had been placed over a non-adhesive portion of the stent graft due to type Ia endoleaks. In the most recent admission, a CT scan showed type III endoleak and ruptured aneurysm sac. On this occasion the patient underwent late open conversion. The failure was repaired with total preservation of the main endovascular graft body and interposition of a bifurcated dacron graft. This case demonstrates that lifelong radiographic surveillance should be considered in this subset of patients. Late open conversion following EVAR of ruptured abdominal aortic aneurysms can be performed safely.
尽管技术不断进步，但血管内主动脉瘤修复术（EVAR）的长期疗效仍存在争议。虽然EVAR术后大多数内支架失败情况可用血管内技术纠正，但仍可能需要开放转换手术。一名70岁男性患者因腹痛就诊于急诊科。在首次修复后的第三年和第四年，由于Ia型内漏，曾两次在支架移植物的非粘连部分上方放置支架移植物。在最近一次入院时，CT扫描显示III型内漏和动脉瘤囊破裂。此次患者接受了晚期开放转换手术。通过完全保留主要血管内移植物主体并置入分叉涤纶移植物修复了失败情况。该病例表明，对此类患者应考虑进行终身影像学监测。腹主动脉瘤破裂后行EVAR术后的晚期开放转换手术可安全进行。
