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在一名因主动脉肠瘘继发失血性休克的患者中,采用鞘管控制技术进行肾下腹主动脉球囊扩张式覆膜支架置入术。

Infrarenal aortic balloon-expandable stent graft deployment using the sheath control technique in a patient with hemorrhagic shock secondary to an aortoenteric fistula.

作者信息

Overfield Cameron J, McCormick Benjamin J, Erben Young, Saunders Hollie, Sheele Johnathan M, Moss John E, Toskich Beau

机构信息

Division of Interventional Radiology, Mayo Clinic, Jacksonville, Fla.

Department of Internal Medicine, Mayo Clinic, Jacksonville, Fla.

出版信息

J Vasc Surg Cases Innov Tech. 2021 May 21;7(3):563-566. doi: 10.1016/j.jvscit.2021.04.025. eCollection 2021 Sep.

DOI:10.1016/j.jvscit.2021.04.025
PMID:34485779
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8406146/
Abstract

A 40-year-old man presented with hemorrhagic shock owing to an aortoduodenal fistula. Angiography demonstrated vasospasm of the right common femoral artery to 2 mm. Treatment using a balloon-expandable stent graft was chosen given the smaller sheath diameter requirement when compared to self-expandable aortic stent graft. Given the undersized 11 mm delivery balloon for the patient's aorta, a sheath control technique was utilized. The stent graft was partially expanded within the sheath and the delivery balloon was exchanged for a 16-mm balloon to complete expansion of the stent graft apposition to the aortic wall, bridging the patient to definitive surgical repair.

摘要

一名40岁男性因主动脉十二指肠瘘出现失血性休克。血管造影显示右股总动脉血管痉挛至2毫米。与自膨胀式主动脉支架移植物相比,鉴于球囊扩张式支架移植物对鞘管直径的要求较小,故选择使用球囊扩张式支架移植物进行治疗。鉴于患者主动脉的输送球囊尺寸过小(11毫米),采用了鞘管控制技术。支架移植物在鞘管内部分扩张,然后将输送球囊换成16毫米的球囊,以完成支架移植物与主动脉壁的完全贴合扩张,使患者过渡到确定性手术修复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/cd9dc82d64c9/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/7924a20534f3/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/f8f35e5f9f58/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/e2d285274574/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/cd9dc82d64c9/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/7924a20534f3/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/f8f35e5f9f58/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/e2d285274574/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8e/8406146/cd9dc82d64c9/gr4.jpg

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本文引用的文献

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Cardiovasc Intervent Radiol. 2016 Jun;39(6):935-9. doi: 10.1007/s00270-015-1249-2. Epub 2015 Dec 1.
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Percutaneous balloon-expandable covered stent implantation for treatment of traumatic aortic injury in children and adolescents.经皮球囊扩张覆膜支架植入术治疗儿童和青少年创伤性主动脉损伤。
Am J Cardiol. 2012 Nov 15;110(10):1541-5. doi: 10.1016/j.amjcard.2012.06.063. Epub 2012 Jul 30.
3
Primary aortoenteric fistula and endovascular repair.
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Vasc Endovascular Surg. 2009 Dec;43(6):592-6. doi: 10.1177/1538574409335275. Epub 2009 Jul 29.
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Gastrointestinal hemorrhage secondary to rupture of aorta. A review of four duodenal and three esophageal cases.主动脉破裂继发胃肠道出血。4例十二指肠病例和3例食管病例的综述。
Arch Intern Med. 1966 Jan;117(1):133-40.