采用复苏性血管内主动脉球囊阻断术分两阶段治疗破裂性腹主动脉瘤。
Ruptured abdominal aortic aneurysm managed using resuscitative endovascular balloon occlusion of the aorta with a two-stage approach.
作者信息
Ishida Kenichiro, Matsumura Yosuke, Kitabayashi Kai, Ogawa Haruka, Tajiri Masashi, Ochi Koichi, Iehara Takashi, Nakagawa Masaya, Shirasaki Yukie, Nishi Hiroyuki, Ohnishi Mitsuo
机构信息
Department of Acute Medicine and Critical Care Medical Center NHO Osaka National Hospital Osaka Japan.
Department of Intensive Care Chiba Emergency and Psychiatry Medical Center Chiba Japan.
出版信息
Acute Med Surg. 2025 Feb 21;12(1):e70048. doi: 10.1002/ams2.70048. eCollection 2025 Jan-Dec.
BACKGROUND
A ruptured abdominal aortic aneurysm (rAAA) is fatal. While Resuscitative endovascular balloon occlusion of the aorta (REBOA) contributes to hemodynamic stability, organ ischemia should be carefully considered.
CASE PRESENTATION
A 69-year-old obese man with untreated hypertension presented with sudden back pain and hypotension. Computed tomography confirmed the presence of an rAAA. REBOA was initially planned in Zone 1 via the left brachial artery but was eventually switched to Zone 3 via the right femoral artery. Hemodynamic stability was achieved through blood transfusion and partial REBOA, followed by surgical intervention. The postoperative recovery was uneventful.
CONCLUSION
Zone 1 REBOA via the left brachial approach provided safe aortic occlusion. Transitioning to Zone 3 REBOA, combined with meticulous organ perfusion management and blood transfusion, prevented ischemia-reperfusion complications.
背景
腹主动脉瘤破裂（rAAA）是致命的。虽然主动脉复苏性血管内球囊阻断术（REBOA）有助于血流动力学稳定，但应仔细考虑器官缺血问题。
病例介绍
一名69岁未治疗高血压的肥胖男性，出现突发背痛和低血压。计算机断层扫描证实存在rAAA。最初计划经左肱动脉在1区进行REBOA，但最终改为经右股动脉在3区进行。通过输血和部分REBOA实现了血流动力学稳定，随后进行了手术干预。术后恢复顺利。
结论
经左肱动脉途径在1区进行REBOA可提供安全的主动脉阻断。过渡到3区REBOA，结合精心的器官灌注管理和输血，可预防缺血再灌注并发症。
Zotero 插件