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腹主动脉瘤血管内修复术后,使用可操纵引导鞘对肾动脉进行快速血管内急救性血运重建。

Rapid endovascular bailout revascularization of the renal arteries with a steerable guiding sheath after endovascular abdominal aortic aneurysm repair.

作者信息

Gu Ningzhi, Grab Jeffery G, Moore Randy D

机构信息

Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Division of Vascular Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.

出版信息

J Vasc Surg Cases Innov Tech. 2021 May 5;7(3):572-576. doi: 10.1016/j.jvscit.2021.04.015. eCollection 2021 Sep.

Abstract

Advancements in endovascular therapy have made it increasingly available for patients with complex cases but not without complications. Unintentional coverage of the renal arteries is a rare occurrence during endovascular aortic aneurysm repair. Given the potentially devastating repercussions, it is important that surgeons understand the suitability and the risks and benefits of the available revascularization options. We have described two cases of unintentional renal coverage, with subsequent successful bailout via direct manipulation of the stent-graft with a steerable sheath. We also conducted a review of the reported data, discussed the breadth of management options and their technical aspects, and provided several distinct solutions.

摘要

血管内治疗的进展使其越来越多地应用于复杂病例的患者,但并非没有并发症。在血管内主动脉瘤修复过程中,意外覆盖肾动脉是一种罕见的情况。鉴于其可能产生的毁灭性后果,外科医生了解可用的血运重建选择的适用性、风险和益处非常重要。我们描述了两例意外肾动脉覆盖的病例,随后通过使用可操纵鞘管直接操作覆膜支架成功实施了补救。我们还对已报道的数据进行了回顾,讨论了管理选择的范围及其技术方面,并提供了几种不同的解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f56/8408573/6f1279e64e91/gr1.jpg

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