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一体式主动脉覆膜支架系统用于治疗肾下腹主动脉夹层的非标签使用

An Off-Label Use of a Unibody Aortic Stent-Graft System for the Treatment of Infrarenal Abdominal Aortic Dissections.

作者信息

Faraj Joseph, Tan Rebekah L W, Mwipatayi Bibombe P

机构信息

Department of Vascular Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.

Department of Vascular Surgery, Hollywood Private Hospital, Western Australia, Australia.

出版信息

Case Rep Vasc Med. 2019 Apr 8;2019:6853135. doi: 10.1155/2019/6853135. eCollection 2019.

Abstract

Infrarenal abdominal aortic dissections (IAAD) are exceedingly rare, accounting for 1-4% of all aortic dissections. The evidence is scarce on how to best manage IAAD when they become symptomatic. Two main interventional approaches exist, open surgery and the endovascular approach. Conventional stent-graft systems make it difficult to treat nonaneurysmal aortic disease due to limb competition in a narrow distal aorta. Thus, we present a novel use of the Endologix Anatomical Fixation 2 (AFX2) Abdominal Aortic Aneurysm (AAA) endograft system for the treatment of four patients with IAAD. We also highlight an individual case study that was treated with an alternative endovascular approach and the complications that followed. This was to highlight and compare our successful experience with Endologix AFX2 AAA endograft system. There were multiple benefits for choosing this stent-graft; however the main advantage is its suitability in the narrow distal aorta. Our aim was to highlight an alternative endovascular approach for the successful treatment of a rare, challenging, and potentially fatal pathology.

摘要

肾下腹主动脉夹层(IAAD)极为罕见,占所有主动脉夹层的1% - 4%。关于有症状的IAAD如何进行最佳治疗,证据稀少。目前存在两种主要的介入方法,即开放手术和血管内介入方法。传统的覆膜支架系统由于在狭窄的远端主动脉中存在肢体竞争,难以治疗非动脉瘤性主动脉疾病。因此,我们展示了Endologix解剖固定2(AFX2)腹主动脉瘤(AAA)腔内移植物系统在治疗4例IAAD患者中的新应用。我们还重点介绍了1例采用替代血管内介入方法治疗的病例及随后出现的并发症。目的是突出并比较我们使用Endologix AFX2 AAA腔内移植物系统的成功经验。选择这种覆膜支架有诸多益处;然而主要优势在于其适用于狭窄的远端主动脉。我们的目的是突出一种替代血管内介入方法,用于成功治疗一种罕见且具有挑战性的潜在致命性病变。

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