Cheng W, Yuan Y
Department of Vascular Surgery, Wuxi People's Hospital, Nanjing Medical University , Jiangsu Province , China.
Ann R Coll Surg Engl. 2018 Oct 5;100(8):e1-e3. doi: 10.1308/rcsann.2018.0148.
In this rare case, an aortocaval fistula caused by a type I endoleak following endovascular repair of an abdominal aortic aneurysm (AAA) in a 75-year-old man was treated successfully with repeat endovascular aortic stent implantation. Postoperatively, the patient's symptoms were significantly improved, and angiography at nine months showed no endoleak in the aneurysm and no occlusion in the compressed inferior vena cava. Endovascular interventional surgery may be a safe and effective approach to treating AAA with concomitant aortocaval fistula. The use of covered stents to isolate the fistula from the venous side may not be necessary in the first stage of surgery.
在这个罕见病例中，一名75岁男性腹主动脉瘤（AAA）血管内修复术后因I型内漏导致主动脉腔静脉瘘，通过再次血管内主动脉支架植入成功治疗。术后，患者症状明显改善，9个月时血管造影显示动脉瘤无内漏，受压下腔静脉无闭塞。血管内介入手术可能是治疗合并主动脉腔静脉瘘的AAA的一种安全有效的方法。在手术第一阶段可能无需使用覆膜支架从静脉侧隔离瘘口。
