Steadman Jessica A, Mendes Bernardo C, Oderich Gustavo S
Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
Department of Cardiothoracic and Vascular Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX.
J Vasc Surg Cases Innov Tech. 2022 Jul 20;8(3):500-504. doi: 10.1016/j.jvscit.2022.05.020. eCollection 2022 Sep.
Fenestrated and branched stent grafts have been used with increasing frequency for endovascular repair of complex aortic aneurysms. Endoleaks are frequently encountered after endovascular aortic aneurysm repair, with treatment indicated when associated with an enlarging aneurysm sac. When endovascular treatment fails, complex open surgical explantation will become necessary. We have reported the technique of partial graft explantation in a patient with a recalcitrant type II endoleak. Both the proximal fenestrated segment and the distal iliac limbs were preserved, and aortic control was obtained by clamping the infrarenal stent graft. This method allowed for more distal aortic cross-clamping and negated the need for visceral branch reimplantation.
开窗和分支型覆膜支架越来越频繁地用于复杂主动脉瘤的血管腔内修复。血管腔内主动脉瘤修复术后经常会出现内漏，当与动脉瘤囊扩大相关时则需进行治疗。当血管腔内治疗失败时，就需要进行复杂的开放手术切除。我们报道了1例难治性Ⅱ型内漏患者的部分移植物切除技术。保留了近端开窗段和远端髂支，通过钳夹肾下覆膜支架实现主动脉控制。该方法允许在更远端进行主动脉交叉钳夹，且无需再次植入内脏分支。
