Imai Akito, Mitomi Kisato, Sato Masataka, Matsuzaki Kanji, Watanabe Yasunori
Department of Cardiovascular Surgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan.
Ann Vasc Dis. 2023;16(4):261-264. doi: 10.3400/avd.avd.cr.23-00038. Epub 2023 Sep 30.
We report a case of endovascular aortic repair (EVAR) for the abdominal aortic aneurysm complicated by a saccular aneurysm due to a penetrating atherosclerotic ulcer in the severely angulated proximal landing zone. To secure the zone, coil embolization of the saccular aneurysm was performed before stent grafting to treat the abdominal aortic aneurysm. To precisely follow the severely angled proximal neck, we used the Excluder stent-graft system inserted by the body floss technique method instead of the stiff wire method to avoid accordion folding the proximal landing zone. These techniques may expand the indications of EVAR.
我们报告了一例腹主动脉瘤合并囊状动脉瘤的血管腔内主动脉修复术（EVAR），该囊状动脉瘤由严重成角的近端锚定区穿透性动脉粥样硬化溃疡引起。为确保该区域安全，在植入支架移植物治疗腹主动脉瘤之前，先对囊状动脉瘤进行了弹簧圈栓塞。为精确追踪严重成角的近端瘤颈，我们采用经体部丝线技术方法插入Excluder支架移植物系统，而非硬导丝方法，以避免近端锚定区出现手风琴样折叠。这些技术可能会扩大EVAR的适应证。
