Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, 36657Kunming Medical University, Kunming, Yunnan, P. R. China.
36657Kunming Medical University, Kunming, Yunnan, P. R. China.
Vasc Endovascular Surg. 2022 Aug;56(6):636-640. doi: 10.1177/15385744221095940. Epub 2022 Apr 30.
Abdominal aortic aneurysm (AAA) with concomitant aorto-retroarotic left renal vein fistula (ALRVF) is an extremely rare clinical condition. With the recent development of endovascular techniques, repair of such conditions with a complete minimal invasive approach is now possible. We reported here a case of endovascular repair of AAA with concomitant ALRVF.
A 62-year-old gentleman presenting with AAA and concomitant ALRVF underwent complete endovascular repair, including an endovascular aortic aneurysm repair (EVAR) with bifurcated aortic graft as well as embolization of the aneurysm sac and deployment of a covered stent in the left retroarotic renal vein to achieve sealing of the arterial-venous fistula. The patient required no blood transfusion and no ICU stay. He has been followed up closely for 4 years and has been well clinically. Aneurysm sac size has remained stable.
Endovascular repair can be a safe and reliable surgical alternative to treat AAA with concomitant ALRVF. But long-term follow up and more clinical data are required to verify the durability of endovascular repair for such conditions.
伴发主动脉-后肾窝左肾静脉瘘（ALRVF）的腹主动脉瘤（AAA）是一种极为罕见的临床情况。随着血管内技术的最新发展，现在可以通过完全微创的方法来修复这些情况。我们在此报告一例伴发 ALRVF 的 AAA 的血管内修复病例。
一位 62 岁的男性，患有 AAA 和伴发的 ALRVF，接受了完全的血管内修复，包括分叉式主动脉移植物的血管内主动脉瘤修复（EVAR），以及对动脉瘤囊的栓塞和在左后肾窝放置一个覆膜支架，以实现动静脉瘘的封闭。患者无需输血，也无需入住 ICU。他已被密切随访 4 年，临床情况良好。动脉瘤囊大小保持稳定。
血管内修复可以作为一种安全可靠的手术替代方法，用于治疗伴发 ALRVF 的 AAA。但需要长期随访和更多的临床数据来验证血管内修复对这些情况的耐久性。
