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肾移植受者腹主动脉瘤的血管内修复术。

Endovascular repair for abdominal aortic aneurysm in a kidney transplant recipient.

作者信息

Thanh Vu Tri, Bang Ho Tat, Phat Nguyen Dinh, Cuong Lam Thao, Dinh Le Quang, Thuy Tran Thi Mai, Vy Tran Thanh

机构信息

Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

Thoracic and Vascular Department, University Medical Center at Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang Street, District 5, Ho Chi Minh City, 72714 Vietnam.

出版信息

Radiol Case Rep. 2020 Oct 15;15(12):2655-2659. doi: 10.1016/j.radcr.2020.10.011. eCollection 2020 Dec.

Abstract

Surgical treatment of abdominal aortic aneurysm in patients with a transplanted kidney is true a challenge. Conventional open repair of the aneurysm requires aortic cross-clamping. Therefore, it can pose a risk of ischemic injury to the transplanted kidney. Endovascular repair, which limits the duration of interruption of blood flow to the transplanted kidney, is a suitable alternative for repair of abdominal aortic aneurysm, if feasible anatomically. Here, we present a case of a 62-year-old woman who was transferred to our hospital because of abdominal pain and had a history of renal transplant 14 years ago. Computed tomography confirmed a large infrarenal fusiform abdominal aortic aneurysm 6 cm in maximal diameter and another 4 cm fusiform aneurysm in the left common iliac artery. We successfully performed endovascular aneurysm repair combined with femoro-femoral bypass. The postoperative course was uneventful, and the patient was discharged on the 5th postoperative day.

摘要

对肾移植患者进行腹主动脉瘤的外科治疗确实是一项挑战。传统的动脉瘤开放修复需要阻断主动脉。因此,它可能会给移植肾带来缺血性损伤的风险。血管内修复可限制移植肾血流中断的持续时间,如果在解剖学上可行,是修复腹主动脉瘤的合适替代方法。在此,我们报告一例62岁女性患者,因腹痛转至我院,14年前有肾移植病史。计算机断层扫描证实有一个最大直径6厘米的巨大肾下型梭形腹主动脉瘤,以及左髂总动脉一个4厘米的梭形动脉瘤。我们成功地进行了血管内动脉瘤修复并联合股-股旁路手术。术后过程顺利,患者术后第5天出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5392/7569263/468117568469/gr1.jpg

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