Mutlu Deniz, Ateş İsmail, Marmagkiolis Konstantinos, Iliescu Cezar A, Çilingiroğlu Mehmet
Department of Cardiology, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Turkey.
Department of Cardiology, Bahçeşehir University Faculty of Medicine, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2022 Dec;50(8):613-616. doi: 10.5543/tkda.2022.22334.
The objective of this article is to describe a patient with hemorrhagic shock due to type 3 postendovascular aortic repair rupture successfully treated with the endurant II stent graft via a primary endovascular approach with a rapid response protocol. A 65-year-old male patient who underwent endovascular aortic repair 3 years ago was admitted to the emergency department with severe abdominal pain and hemorrhagic shock. The patient was rapidly taken to the angiography laboratory, and aortography demonstrated distal aortic graft rupture and extravasation of contrast media. The repair was performed successfully with 3 stent-grafts by paying attention to rupture localization and renal artery ostia. The hemodynamics of the patient improved very quickly, and the patient was discharged after 5 days. Emergency primary stent grafting using a rapid response protocol could be a crucial alternative to open surgery for late endoleaks, which are complicated with hemorrhagic shock.
本文的目的是描述1例3型血管腔内主动脉修复术后破裂导致出血性休克的患者，通过采用快速反应方案的初次血管腔内入路，成功使用Endurant II覆膜支架移植物进行治疗。1例3年前接受血管腔内主动脉修复术的65岁男性患者因严重腹痛和出血性休克入住急诊科。患者被迅速送往血管造影实验室，主动脉造影显示远端主动脉移植物破裂及造影剂外渗。通过关注破裂部位和肾动脉开口，成功使用3个覆膜支架移植物进行了修复。患者的血流动力学很快得到改善，5天后出院。对于并发出血性休克的晚期内漏，采用快速反应方案进行急诊初次覆膜支架置入术可能是开放手术的关键替代方案。
