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胸主动脉假性动脉瘤经皮椎弓根螺钉植入术后血管内修复:8 年随访的病例报告。

Endovascular repair for thoracic aortic pseudoaneurysm induced by pedicle screw implantation: a case report with 8 years follow-up.

机构信息

State Key Laboratory of Cardiovascular Disease, Center of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.

The Second Hospital of Jilin University, Changchun, 130041, China.

出版信息

J Cardiothorac Surg. 2024 Jun 7;19(1):326. doi: 10.1186/s13019-024-02820-w.

DOI:10.1186/s13019-024-02820-w
PMID:38849846
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11157916/
Abstract

BACKGROUND

Pedicle screw instrument surgeries can result in the development of aortic pseudoaneurysm, which is a rare yet potentially severe complication; therefore, the purpose of this work is to describe the case of pseudoaneurysm of the thoracic aorta caused by the severe migration of a pedicle screw after surgery.

CASE PRESENTATION

We herein report a patient who underwent endovascular repair for the pseudoaneurysm of the descending thoracic aorta following thoracic vertebral fixation surgery. A 28-80 mm covered stent was initially inserted through the right femoral artery, and intraoperative aortography revealed a minor extravasation of contrast material. Subsequently, an additional 28-140 mm covered stent was implanted. The patient recovered well during the 8-year follow-up period.

CONCLUSIONS

Vascular complications resulting from spinal surgery are severe and rare, necessitating early diagnosis and intervention.

摘要

背景

椎弓根螺钉器械手术可导致主动脉假性动脉瘤的发生,这是一种罕见但潜在严重的并发症;因此,本研究旨在描述术后椎弓根螺钉严重移位导致的胸主动脉假性动脉瘤病例。

病例介绍

我们在此报告 1 例胸腰椎固定术后发生降主动脉假性动脉瘤的患者,采用经股动脉入路置入初始 28-80mm 覆膜支架,术中主动脉造影显示少量造影剂外渗,随后植入额外的 28-140mm 覆膜支架。患者在 8 年的随访期间恢复良好。

结论

脊柱手术后发生的血管并发症严重且罕见,需要早期诊断和干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec1/11157916/a15e1fbe9d52/13019_2024_2820_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec1/11157916/591b7990eb58/13019_2024_2820_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec1/11157916/a15e1fbe9d52/13019_2024_2820_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec1/11157916/591b7990eb58/13019_2024_2820_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec1/11157916/a15e1fbe9d52/13019_2024_2820_Fig2_HTML.jpg

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2
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J Vasc Surg Cases. 2015 Nov 7;1(4):264-267. doi: 10.1016/j.jvsc.2015.09.001. eCollection 2015 Dec.
3
Aortic Injury by Thoracic Pedicle Screw. When Is Aortic Repair Required? Literature Review and Three New Cases.
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4
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Delayed Presentation of Aortic Injury by a Thoracic Pedicle Screw.胸段椎弓根螺钉致主动脉损伤的延迟表现
J Card Surg. 2016 Apr;31(4):220-30. doi: 10.1111/jocs.12718. Epub 2016 Feb 10.
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