Li Hai-Lei, Cui Dong-Zhe, Chan Yiu Che, Tam Siu-Chung, Cheng Stephen W
Division of Vascular Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Division of Vascular Surgery, Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
J Vasc Surg Cases Innov Tech. 2024 Sep 19;10(6):101634. doi: 10.1016/j.jvscit.2024.101634. eCollection 2024 Dec.
A 64-year-old man presented with severe intermittent claudication for 4 weeks. Computed tomography angiography showed aortoiliac occlusion. Aortoiliac thrombectomy and followed by covered endovascular reconstruction of aortic bifurcation was performed successfully. On-table fenestration technique was used for preservation of inferior mesenteric artery (IMA) to minimize the risk of bowel ischemia. A follow-up computed tomography scan at 6 weeks showed aortoiliac artery and IMA were patent and patient was asymptomatic at 6 months follow-up. Comprehensive management with thrombectomy, covered endovascular reconstruction of the aortic bifurcation, and concurrent on-table fenestration for IMA preservation was an alternative novel, effective, and safe approach for treatment of complex aortoiliac occlusion.
一名64岁男性因严重间歇性跛行4周就诊。计算机断层血管造影显示主髂动脉闭塞。成功进行了主髂动脉血栓切除术，随后进行了主动脉分叉覆膜血管腔内重建术。术中采用开窗技术保留肠系膜下动脉（IMA），以尽量降低肠缺血风险。6周后的计算机断层扫描随访显示主髂动脉和IMA通畅，患者在6个月随访时无症状。血栓切除术、主动脉分叉覆膜血管腔内重建术以及同时进行的术中IMA保留开窗术的综合治疗是治疗复杂性主髂动脉闭塞的一种新颖、有效且安全的替代方法。
