Takahashi Baku, Kamiya Shinji, Ohta Kengo, Mori Yoshiharu, Yamada Toshiyuki, Nakai Yosuke, Suda Hisao, Mishima Akira
Department of Cardiovascular Surgery, Nagoya City University Hospital, Nagoya, Aichi, Japan.
Department of Radiology, Nagoya City University Hospital, Nagoya, Aichi, Japan.
Ann Vasc Dis. 2020 Dec 25;13(4):457-460. doi: 10.3400/avd.cr.20-00109.
A 75-year-old man underwent emergent endovascular aortic repair for a ruptured abdominal aortic aneurysm. Two years later, computed tomography revealed aneurysm enlargement with endoleaks. Next, late open conversion was performed. Intraoperatively, we detected a spurting type II endoleak from an artery within the aneurysmal wall, which was unconnected to any branch vessels outside the aneurysm, and surgical ligation and sacotomy was performed uneventfully. To our knowledge, this is the first report to intraoperatively identify a type II endoleak from an artery within the aneurysm wall. Even for atypical type II endoleak, such as this case, open surgical repair should be effective.
一名75岁男性因腹主动脉瘤破裂接受了急诊血管内主动脉修复术。两年后，计算机断层扫描显示动脉瘤扩大并伴有内漏。接下来，进行了晚期开放转换手术。术中，我们发现动脉瘤壁内的一条动脉出现喷射性II型内漏，该动脉与动脉瘤外的任何分支血管均无连接，手术结扎和瘤囊切开术顺利完成。据我们所知，这是第一份术中识别出动脉瘤壁内动脉发生II型内漏的报告。即使对于这种非典型的II型内漏，如本病例，开放手术修复也应是有效的。
