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开放手术与血管内技术治疗急性腹主动脉动静脉瘘

Open Surgery and Endovascular Techniques in Treatment of Acute Abdominal Arteriovenous Fistulas.

作者信息

Borghese Ottavia, Pisani Angelo, Sbenaglia Giorgio, Giudice Rocco

机构信息

Department of Vascular and Endovascular Surgery, San Giovanni- Addolorata Hospital, Rome, Italy.

Department of Cardiothoracic Surgery, Bichat-Claude Bernard Hospital, Paris, France.

出版信息

Ann Vasc Surg. 2019 Nov;61:427-433. doi: 10.1016/j.avsg.2019.03.041. Epub 2019 Jun 14.

Abstract

Acute abdominal arteriovenous fistulas in the setting of ruptured abdominal aortic aneurysms are a life-threatening condition; thus, a prompt diagnosis is required for proper treatment. Open, endovascular, and hybrid repair have been proposed for their management, with pros and cons for each method. In particular, the evolution of endoluminal techniques guarantees an increasing feasibility of these procedures, and a significant reduction in morbidity and mortality rates was usually associated with open surgery. Nevertheless, some concerns still remain regarding the midterm and long-term follow-up. The aim of this article was to review and compare the reported clinical and technical results of conventional open surgery and endoluminal techniques in this scenario and to report the case of an acute aorto-iliac fistula due to a ruptured common iliac artery aneurysm into the iliac vein that was managed by endovascular repair at our institution.

摘要

腹主动脉瘤破裂时出现的急性腹部动静脉瘘是一种危及生命的疾病;因此,需要及时诊断以便进行恰当治疗。对于其治疗,已提出开放手术、血管腔内修复术和杂交修复术,每种方法都有其优缺点。特别是,腔内技术的发展确保了这些手术的可行性不断提高,而且与开放手术相比,发病率和死亡率通常显著降低。然而,关于中期和长期随访仍存在一些问题。本文的目的是回顾和比较在这种情况下传统开放手术和腔内技术已报道的临床和技术结果,并报告我院通过血管腔内修复术治疗的一例因髂总动脉瘤破裂至髂静脉导致的急性主-髂动静脉瘘病例。

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