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伴有间歇性跛行和盆腔异位肾患者的主髂动脉闭塞性疾病的血管内重建术

Endovascular reconstruction of aortoiliac occlusive disease in a case with claudication and an ectopic pelvic kidney.

作者信息

Salimi Javad, Mirhashemi Mahta, Miratashi Yazdi Seyed Amir

机构信息

Vascular & Endovascular Surgeon, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Ann Med Surg (Lond). 2021 Dec 21;73:103205. doi: 10.1016/j.amsu.2021.103205. eCollection 2022 Jan.

Abstract

INTRODUCTION AND IMPORTANCE

Ectopic kidney is a rare anomaly with an incidence of about 1 in 2500 birth in the population. Concurrency of pelvic kidney and iliac occlusion is rare, and the treatment is challenging because the pelvic kidney is associated with an atypical blood supply.

CASE PRESENTATION

We reported a 68-year-old man with aortoiliac stenosis, right pelvic kidney, and high-risk cardiovascular comorbidities. He presented with the right lower extremity claudication that has been present for four years. Computed tomography angiograms showed total occlusion of right common and external iliac arteries.

CLINICAL DISCUSSION

The old method for treating iliac artery stenosis is open surgery, which needs cross-clamping of the aorta. During this procedure, the chance of renal thrombosis and ischemia is high. Thus, the patient underwent an endovascular angioplasty that was done successfully for the patient without any disturbances in kidney function.

CONCLUSION

Traditional treatment of iliac artery stenosis, especially in patients with high-risk cardiovascular comorbidities, may be associated with complications. Endovascular intervention is a safe and effective approach for treating aortoiliac occlusion in patients with ectopic pelvic kidneys. More research and case series are needed to review the results and compare the success rate of this method versus open surgery.

摘要

引言与重要性

异位肾是一种罕见的异常情况,在人群中的发病率约为2500例出生中有1例。盆腔肾与髂动脉闭塞同时存在的情况罕见,且由于盆腔肾的血供不典型,治疗具有挑战性。

病例介绍

我们报告了一名68岁男性,患有主髂动脉狭窄、右盆腔肾及高危心血管合并症。他出现右下肢间歇性跛行已四年。计算机断层扫描血管造影显示右髂总动脉和髂外动脉完全闭塞。

临床讨论

治疗髂动脉狭窄的旧方法是开放手术,需要对主动脉进行交叉钳夹。在此过程中,肾血栓形成和缺血的几率很高。因此,该患者接受了血管腔内血管成形术,手术成功,且肾功能未受到任何干扰。

结论

髂动脉狭窄的传统治疗方法,尤其是在有高危心血管合并症的患者中,可能会伴有并发症。血管腔内介入治疗是治疗异位盆腔肾患者主髂动脉闭塞的一种安全有效的方法。需要更多的研究和病例系列来评估结果,并比较该方法与开放手术的成功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b83/8715058/e086b8550a9d/gr1.jpg

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