Sano Masaya, Hashimoto Takuya, Saito Mio, Kimura Masaru, Miyazaki Masaya, Deguchi Juno
Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Department of Radiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
J Surg Case Rep. 2023 Mar 11;2023(3):rjad087. doi: 10.1093/jscr/rjad087. eCollection 2023 Mar.
Identification and control of responsible feeding arteries are crucial in treating type II endoleaks after endovascular aortic repair (EVAR). A 78-year-old female patient required management of a type II endoleak 8 years after EVAR. A persistent endoleak from the inferior mesenteric artery (IMA) enlarged the size of an aneurysm sac. Sac angiography from the IMA revealed a flow-through endoleak from the IMA to an aberrant renal artery (ARA). After coil embolization of the ARA through the sac together with the IMA, the sac shrank. Control of flow-through vessels may be essential for managing post-EVAR enlargement due to type II endoleaks.
识别并控制责任供血动脉对于治疗血管腔内主动脉修复术（EVAR）后II型内漏至关重要。一名78岁女性患者在EVAR术后8年需要处理II型内漏。肠系膜下动脉（IMA）持续存在的内漏使动脉瘤囊增大。IMA的囊造影显示存在从IMA到异常肾动脉（ARA）的血流内漏。通过囊与IMA一起对ARA进行弹簧圈栓塞后，囊缩小。控制血流通过的血管对于处理因II型内漏导致的EVAR术后瘤体增大可能至关重要。
