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经皮臀动脉穿刺通路用于栓塞马凡氏综合征患者B型主动脉夹层的假腔。

Percutaneous gluteal artery access to embolize false lumen of type B aortic dissection in marfan patient.

作者信息

Dajci Ada, Mohseni Alireza, Di Girolamo Alessia, Nardis Pier Giorgio, di Marzo Luca, Mansour Wassim

机构信息

Department of General Surgery and Surgical Specialties, Sapienza University of Rome, Rome, Italy.

出版信息

J Vasc Surg Cases Innov Tech. 2024 Jun 5;10(5):101553. doi: 10.1016/j.jvscit.2024.101553. eCollection 2024 Oct.

DOI:10.1016/j.jvscit.2024.101553
PMID:39069989
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11277389/
Abstract

This case study presents an innovative endovascular approach using percutaneous gluteal artery access for embolizing the false lumen of a type B aortic dissection in a patient with Marfan syndrome. Following multiple complex surgeries, the patient developed an enlarging thoraco-abdominal aneurysm, necessitating an urgent intervention branched endoprosthesis despite persisting false lumen perfusion. Doppler ultrasound-guided percutaneous gluteal access was utilized for spiral-coil embolization of the false lumen. Successful embolization and exclusion of the aneurism, confirmed by follow-up angiography and computed tomography scans, demonstrated the technique's efficacy and safety. This approach underscores the need for innovative solutions addressing complex vascular pathologies in patients with Marfan.

摘要

本病例研究展示了一种创新的血管内治疗方法，即通过经皮臀动脉穿刺入路，对一名患有马凡综合征的B型主动脉夹层患者的假腔进行栓塞。在经历多次复杂手术后，患者出现了不断增大的胸腹主动脉瘤，尽管假腔仍有血流灌注，但仍需要紧急干预并植入分支型血管内支架。采用多普勒超声引导下经皮臀动脉穿刺入路，对假腔进行螺旋线圈栓塞。随访血管造影和计算机断层扫描证实，成功栓塞并排除了动脉瘤，证明了该技术的有效性和安全性。这种方法强调了针对马凡综合征患者复杂血管病变寻求创新解决方案的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf6/11277389/6ad27ec590a6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf6/11277389/ba029daf0bed/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf6/11277389/c5e2ff90ac70/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf6/11277389/6ad27ec590a6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf6/11277389/ba029daf0bed/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf6/11277389/c5e2ff90ac70/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf6/11277389/6ad27ec590a6/gr3.jpg

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本文引用的文献

1
Embolization of Large Internal Iliac Artery Pseudoaneurysm through a Retrograde Trans-Superior Gluteal Arterial Access.经逆行跨臀上动脉入路栓塞大型髂内动脉假性动脉瘤。
Tomography. 2022 Aug 24;8(5):2107-2112. doi: 10.3390/tomography8050177.
2
Inferior gluteal artery surgical access for embolization of large internal iliac artery aneurysm in a hostile abdomen.臀下动脉手术入路用于在复杂腹腔中栓塞髂内动脉大动脉瘤
J Surg Case Rep. 2019 Apr 6;2019(4):rjz098. doi: 10.1093/jscr/rjz098. eCollection 2019 Apr.
3
Direct puncture of superior gluteal artery using a Doppler ultrasound-guided needle to access jailed internal iliac artery aneurysm.
使用多普勒超声引导针直接穿刺臀上动脉以进入被困的髂内动脉瘤。
J Vasc Surg Cases Innov Tech. 2018 Dec 31;5(1):12-13. doi: 10.1016/j.jvscit.2018.09.004. eCollection 2019 Mar.
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Endovascular therapy in Marfan syndrome: PRO.马凡综合征的血管内治疗：支持观点。
Ann Cardiothorac Surg. 2017 Nov;6(6):672-676. doi: 10.21037/acs.2017.10.06.
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Percutaneous transgluteal coil embolization of bilateral internal iliac artery aneurysms via direct superior gluteal artery access.经直接臀上动脉入路对双侧髂内动脉瘤进行经皮经臀线圈栓塞术。
J Vasc Surg. 2014 Jul;60(1):226-9. doi: 10.1016/j.jvs.2013.06.053. Epub 2013 Jul 26.
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Direct sonographic-guided superior gluteal artery access for treatment of a previously treated expanding internal iliac artery aneurysm.直接超声引导下臀上动脉入路治疗复发性髂内动脉扩张性动脉瘤。
J Vasc Surg. 2014 Jan;59(1):235-7. doi: 10.1016/j.jvs.2013.03.001. Epub 2013 May 1.
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[Marfan's syndrome presented with dissected thoraco-abdominal aneurism and pregnancy. A case report].[马凡氏综合征合并胸腹主动脉夹层瘤及妊娠：一例报告]
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The distal aorta in the Marfan syndrome.马凡综合征的主动脉远端。
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[Survival and complications in remote period of follow-up in patients with Marfan syndrome after correction of aneurism of the ascending aorta and aortic insufficiency].
Kardiologiia. 2007;47(8):53-6.
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Surgical access of the gluteal artery to embolize a previously excluded, expanding internal iliac artery aneurysm.通过手术暴露臀动脉，以栓塞先前排除在外但仍在扩大的髂内动脉瘤。
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