Oliveira Fábio Augusto Cypreste, Coelho Bruno Campos, Balestra Marina, Oliveira Juliana Caetano Barreto Cypreste, Amorelli Maria Cunha Ribeiro, Heckmann Davi Douglas, Amorelli Carlos Eduardo de Sousa, Campedelli Fábio Lemos
Hospital São Francisco de Assis, Serviço de Cirurgia Vascular e Endovascular, Goiânia, GO, Brasil.
Universidade Federal de Goiás - UFG, Hospital das Clínicas, Angiorradiologia e Cirurgia Endovascular, Goiânia, GO, Brasil.
J Vasc Bras. 2024 Oct 4;23:e20200028. doi: 10.1590/1677-5449.202000282. eCollection 2024.
Abdominal aortic aneurysms can constitute a therapeutic challenge in several anatomical scenarios, making endovascular treatment more complex. A juxtarenal abdominal aortic aneurysm (JR-AAA) is defined by the absence of a proximal landing zone in the infrarenal segment and, therefore, techniques must be used to obtain an adequate neck for fixing the endoprostheses without provoking occlusion of renal arteries and visceral branches. The parallel grafts technique, physician-modified stent-graft, industry customized endoprostheses, and off-the-shelf branched endoprosthesis are techniques used in abdominal aneurysms with inadequate proximal neck, but each technique has its indications, limitations, and risks. In this therapeutic challenge, we present a case of urgent endovascular treatment of a JR-AAA using a parallel grafts technique, with good medium-term results, and discuss the therapeutic options.
腹主动脉瘤在多种解剖情况下可能构成治疗挑战，使血管内治疗更加复杂。肾旁腹主动脉瘤（JR-AAA）的定义是肾下段缺乏近端着陆区，因此，必须采用一些技术来获得足够的颈部以固定腔内移植物，同时又不引起肾动脉和内脏分支的闭塞。平行移植物技术、医生改良的覆膜支架、定制的腔内移植物和现成的分支腔内移植物是用于近端颈部不足的腹主动脉瘤的技术，但每种技术都有其适应证、局限性和风险。在这一治疗挑战中，我们展示了1例采用平行移植物技术对JR-AAA进行紧急血管内治疗的病例，中期效果良好，并讨论了治疗选择。
