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腔内修复术后未行弹簧圈栓塞的髂内动脉直接穿刺栓塞术——血管封堵器的一种新用途

Direct puncture embolisation of the non-coil-embolised internal iliac artery post EVAR - a novel use of the Angio-Seal closure device.

作者信息

Menon Prashant Ravindran, Agarwal Sanjay, Rees Owen

机构信息

1North Wales School of Radiology, Department of Radiology, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD UK.

2Department of Radiology, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD UK.

出版信息

CVIR Endovasc. 2018;1(1):6. doi: 10.1186/s42155-018-0012-6. Epub 2018 Jun 28.

DOI:10.1186/s42155-018-0012-6
PMID:30652139
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6319503/
Abstract

BACKGROUND

Coil embolisation of the internal iliac arteries prior to EVAR is considered standard treatment to prevent a type 2 endoleak when extending an iliac limb into the EIA. Type 2 endoleaks that arise from a non-coil-embolised internal iliac artery can be challenging to treat due to difficult access.

CASE PRESENTATION

We present a case of a type 2 endoleak from the internal iliac artery that was not coiled prior to EVAR. This was treated with retrograde embolisation of the internal iliac artery via direct puncture of a branch from the buttock and closure of the arteriotomy was achieved using an Angio-Seal (Terumo) device that was deployed in an off-label manner to allow visualisation.

CONCLUSION

This is a viable technique for treating type 2 endoleaks when antegrade access to the internal iliac artery is lost due to the presence of the stent graft and the arteriotomy can be safely closed with an Angio-Seal.

摘要

背景

在进行腹主动脉瘤腔内修复术（EVAR）之前，对髂内动脉进行弹簧圈栓塞被认为是标准治疗方法，可防止在将髂支延伸至髂外动脉（EIA）时出现2型内漏。由于进入困难，源自未进行弹簧圈栓塞的髂内动脉的2型内漏可能难以治疗。

病例报告

我们报告一例在EVAR之前未对髂内动脉进行弹簧圈栓塞而出现的2型内漏病例。通过直接穿刺臀部的一个分支对髂内动脉进行逆行栓塞治疗该内漏，并使用以非标签方式部署的Angio-Seal（泰尔茂）装置实现动脉切开术的闭合，以利于可视化。

结论

当由于存在覆膜支架而无法顺行进入髂内动脉且动脉切开术可使用Angio-Seal安全闭合时，这是一种治疗2型内漏的可行技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/ec856a7e80a6/42155_2018_12_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/41802be8c280/42155_2018_12_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/dc6d17d8158d/42155_2018_12_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/25142b0305c7/42155_2018_12_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/3ab5e1d84847/42155_2018_12_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/ec856a7e80a6/42155_2018_12_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/41802be8c280/42155_2018_12_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/dc6d17d8158d/42155_2018_12_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/25142b0305c7/42155_2018_12_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/3ab5e1d84847/42155_2018_12_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c48/6963994/ec856a7e80a6/42155_2018_12_Fig5_HTML.jpg

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