Kojima Shunsuke, Nakama Tatsuya, Obunai Kotaro, Watanabe Hiroyuki
Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan.
JRSM Cardiovasc Dis. 2021 Jun 30;10:20480040211027792. doi: 10.1177/20480040211027792. eCollection 2021 Jan-Dec.
An 86-year-old woman was admitted for a ruptured popliteal artery aneurysm (rPAA, 26 × 28 mm). Due to the patient's age and comorbidities, emergency endovascular repair was performed. After the failed antegrade guidewire crossing, a retrograde approach from the anterior tibial artery and snaring was performed for lesion crossing, and stentgraft (5 × 50 mm) was deployed from antegrade fashion. At the 14-month follow-up, computed tomography angiogram demonstrated stentgraft patency and reduced aneurysmal size. Although open surgery remains the first-line treatment for infected rPAA, our approach adds to the evidence and can be applied to emergency cases or high-risk surgical patients.
一名86岁女性因腘动脉动脉瘤破裂（rPAA，26×28mm）入院。鉴于患者的年龄和合并症，进行了急诊血管腔内修复术。顺行导丝通过失败后，采用经胫前动脉逆行入路并圈套技术穿过病变，然后以顺行方式植入覆膜支架（5×50mm）。在14个月的随访中，计算机断层血管造影显示覆膜支架通畅且动脉瘤大小减小。尽管开放手术仍是感染性rPAA的一线治疗方法，但我们的方法为相关证据增添了内容，可应用于急诊病例或高风险手术患者。
