Kakkos Stavros K, Apostolopoulou Paraskevi G, Ntouvas Ioannis, Dimitrakopoulou Kalliopi, Kalogeropoulou Christina, Zampakis Peter
Department of Vascular Surgery, School of Medicine of University of Patras, Patras, Greece.
Department of Anesthesiology and Intensive Care, School of Medicine of University of Patras, Patras, Greece.
Vasc Specialist Int. 2021 Mar 31;37(1):41-45. doi: 10.5758/vsi.200073.
We report a case of successful open repair of a 7.5-cm juxtarenal abdominal aortic aneurysm (AAA) in the presence of a left-sided inferior vena cava (LS-IVC) crossing the aorta at the level of the renal arteries in a 72-year-old man. The orifice of the right renal artery was slightly caudal to that of the left renal artery and concomitant occlusive diseases of both iliac arteries were present. Based on the imaging and intraoperative findings, repair of the juxtarenal AAA was performed with mobilization of the LS-IVC, which was encircled twice with soft silicone rubber vessel loops on both sides of operating field and the blood content of the LS-IVC was temporarily evacuated. This procedure allowed proximal control with inter-renal clamping of the aorta and placement of an aortobifemoral polytetrafluoroethylene graft.
我们报告了一例成功开放修复7.5厘米肾旁腹主动脉瘤（AAA）的病例，该病例为一名72岁男性，存在左侧下腔静脉（LS-IVC）在肾动脉水平穿过主动脉的情况。右肾动脉开口略低于左肾动脉开口，且双侧髂动脉均伴有闭塞性疾病。基于影像学和术中发现，通过游离LS-IVC进行肾旁AAA修复，在手术野两侧用柔软的硅橡胶血管环将LS-IVC环绕两次，并暂时排空LS-IVC内的血液。该操作允许在肾动脉间夹闭主动脉以进行近端控制，并置入主动脉双股聚四氟乙烯移植物。
