Figueiredo Braga Sandra, Correia Simões João, Carrilho Celso, Ferreira Joana, Mesquita Amílca
Serviço de Angiologia e Cirurgia Vascular, Hospital da Senhora da Oliveira, Guimarães, Portugal.
Rev Port Cir Cardiotorac Vasc. 2019 Oct-Dec;26(4):279-283.
The authors describe a clinical case of correction of a type 1A endoleak after EVAR using endo-anchors. An 85-year old female was referred due to an abdominal aortic aneurysm. The patient´s previous medical history included hypertension, dyslipidemia, renal insufficiency and multiple abdominal surgeries (appendicectomy, classic cholecystectomy and hysterectomy). The aneurysm had 7.5 cm diameter with an angulated short 14 mm neck extension. She underwent an uneventful EVAR with placement of a Medtronic® Endurant II stentgraft. One month after the procedure the abdominal computed tomographic angiography (CTA) revealed a type 1A endoleak. Correction of endoleak consisted of left renal artery stenting (the lowest one), placement of a proximal aortic cuff and 9 endo-anchors (APTUS® System) with satisfactory end result. The control CTA after re-intervention showed patency of the renal arteries and the stentgraft, aneurysm exclusion and absence of endoleaks.
作者描述了一例使用腔内锚定装置修复腔内修复术后1A型内漏的临床病例。一名85岁女性因腹主动脉瘤前来就诊。患者既往病史包括高血压、血脂异常、肾功能不全以及多次腹部手术(阑尾切除术、传统胆囊切除术和子宫切除术)。动脉瘤直径为7.5 cm,颈部短且呈角状,延伸14 mm。她接受了顺利的腔内修复术,植入了美敦力公司的Endurant II覆膜支架移植物。术后1个月,腹部计算机断层血管造影(CTA)显示存在1A型内漏。内漏的修复包括左肾动脉支架置入(最低的一支)、近端主动脉袖带置入以及9个腔内锚定装置(APTUS®系统),最终结果令人满意。再次干预后的对照CTA显示肾动脉和覆膜支架移植物通畅、动脉瘤被排除且无内漏。