Yu Yasong, Epstein Steven, Padberg Frank T
Section of Vascular Surgery, Veterans Affairs New Jersey Healthcare System, East Orange, NJ, USA.
Division of Vascular Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Vascular. 2025 Aug;33(4):841-844. doi: 10.1177/17085381241273299. Epub 2024 Aug 8.
ObjectiveTo assess viability and safety of preemptive treatment of type II endoleak for abdominal aortic aneurysm (AAA) repairs.MethodsA 69-year-old man with renal fusion (horseshoe kidney) was referred for treatment of a 5.5 cm AAA. His anatomy was suitable for endovascular repair. The risk for type II endoleak was increased because of multiple infrarenal arterial orifices originating within the aneurysm sac. These included an accessory renal artery that supplied the renal isthmus, a patent inferior mesenteric artery, and a pair of large lumbar arteries originating from a single orifice (8 mm) at L3 spinal level. The lumbar orifice was selectively cannulated and occluded with thrombogenic coils 1 week prior to his endovascular aneurysm repair.ResultsAneurysm repair was uneventful with no signs of early or delayed endoleak and long-term follow-up of 5 years.ConclusionsPreemptive coil embolization of perianeurysmal arteries may be considered as a safe and effective strategy for management of potential type II endoleak.
目的
评估腹主动脉瘤（AAA）修复术中对II型内漏进行预防性治疗的可行性和安全性。
方法
一名69岁的马蹄肾男性因5.5厘米的AAA接受治疗。其解剖结构适合血管内修复。由于动脉瘤腔内起源的多个肾下动脉开口，II型内漏的风险增加。这些包括供应肾峡部的副肾动脉、一条通畅的肠系膜下动脉以及一对起源于L3椎体水平单个开口（8毫米）的大腰动脉。在其血管内动脉瘤修复术前1周，对腰动脉开口进行选择性插管并用致血栓性线圈闭塞。
结果
动脉瘤修复过程顺利，无早期或延迟内漏迹象，随访5年。
结论
对于潜在的II型内漏，可考虑对动脉瘤周围动脉进行预防性线圈栓塞，作为一种安全有效的治疗策略。
