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孤立性髂动脉动脉瘤合并先天性盆腔肾采用髂支器械治疗:病例报告。

Isolated iliac artery aneurysm in association with congenital pelvic kidney treated with iliac branch device: case report.

机构信息

Hospital Alemão Osvaldo Cruz, R. Treze, de Maio, 1815, São Paulo, 01323-020, Brazil.

Cava endovascular, Paulista Ave. 91, Suite 909, São Paulo, SP, 01311-000, Brazil.

出版信息

J Cardiothorac Surg. 2021 Mar 17;16(1):26. doi: 10.1186/s13019-021-01409-x.

Abstract

BACKGROUND

Association of abdominal aortic aneurysm with congenital pelvic kidney is rare and association with isolated iliac artery aneurysm is not yet described in the literature.

CASE PRESENTATION

We present a case of successful repair of an isolated common iliac artery aneurysm associated with a congenital pelvic kidney treated by an endovascular technique. A 75-year-old man was referred for the treatment of an asymptomatic left common iliac artery aneurysm. A computed tomography angiography revealed an isolated left common iliac artery aneurysm and a left pelvic kidney. The maximum diameter of the aneurysm was 32 mm. The congenital pelvic kidney was supplied by three small superior polar arteries that emerged from the proximal non-aneurysmal portion of the common iliac artery and the main artery that arose from the left internal iliac artery. The aneurysm exclusion was accomplished by using an iliac branch device (Gore Excluder Iliac Branch, Flagstaff, AZ). The 1 and 6 months computed tomography angiography after the procedure demonstrated complete exclusion of the aneurysm and preservation of all renal arteries.

CONCLUSION

Treating patients with an association of iliac artery aneurysms and pelvic kidneys can be a challenge due the variable arterial anatomy. The use of iliac branch device is a safe and effective alternative in selected cases.

摘要

背景

腹主动脉瘤与先天性盆腔肾相关联较为罕见,而孤立性髂动脉瘤与先天性盆腔肾相关联在文献中尚未描述。

病例介绍

我们报告了一例成功治疗孤立性髂总动脉瘤合并先天性盆腔肾的病例,该病例采用了血管内技术。一名 75 岁男性因无症状性左侧髂总动脉瘤就诊。计算机断层血管造影显示左侧髂总动脉瘤和左侧盆腔肾。动脉瘤最大直径为 32mm。先天性盆腔肾由三个小的上极动脉供应,这些动脉从髂总动脉的近段非动脉瘤部分和发自左侧髂内动脉的主动脉发出。通过使用髂分支装置(戈尔髂分支 Excluder,Flagstaff,AZ)完成了动脉瘤排除。手术后 1 个月和 6 个月的计算机断层血管造影显示完全排除了动脉瘤并保留了所有肾动脉。

结论

由于动脉解剖结构的多样性,治疗髂动脉瘤和盆腔肾并存的患者可能具有挑战性。在选择的病例中,使用髂分支装置是一种安全有效的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cebf/7967968/1f0699e06e03/13019_2021_1409_Fig1_HTML.jpg

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