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在局部麻醉下使用分叉型覆膜支架对一名髂动脉慢性闭塞患者进行腹主动脉瘤腔内修复术:病例报告

Endovascular repair of an abdominal aortic aneurysm under local anesthesia using bifurcated stent graft in a patient with iliac artery chronic occlusion:A case report.

作者信息

Yilmaz Seyhan, Çam İsa, Zengin Sabür

机构信息

Çorlu Province Hospital, Department of Cardiovascular Surgery, Tekirdağ,Turkey.

Assoc. Prof. Dr., Kocaeli University Faculty of Medicine, Department of Radiology, Kocaeli,Turkey.

出版信息

ARYA Atheroscler. 2022 May;18(5):2382. doi: 10.48305/arya.2022.11751.2382. Epub 2022 Dec 15.

Abstract

BACKGROUND

There are some clinical conditions described in literature which limit the application of full endovascular aneurysm repair, and the most important of these limitations are inappropriately short and angled aneurysm neck, narrow terminal aorta, and curved and very small diameter or highly calcified iliac arteries that make access difficult, and unilateral iliac artery occlusion is another one of these limitations, which is less frequently observed.

CASE REPORT

In our case report, we present a patient whose abdominal aortic aneurysm was considered to be high risk for classical open surgical repair. Our patient has a unilateral iliac artery occlusion co-existing with abdominal aortic aneurysm and the occluded left common iliac artery and severely stenotic external iliac artery segment was applied percutaneous transluminal balloon dilatation and after which abdominal aortic aneurysm was successfully treated with standard endovascular aneurysm repair.

CONCLUSION

A standard successful endovascular aneurysm repair procedure was applied for the patient who did not develop any intraoperative complications. The left iliac artery blood flow was also ensured by the dilatation of occluded iliac artery segment, simultaneously. When there are such limitations related to the iliac artery as iliac artery occlusion, the standard endovascular aneurysm repair procedure combined with invasive techniques for iliac artery revascularization is a practical and safe treatment option which reduces the procedural morbidity and mortality compared to the other treatment options.

摘要

背景

文献中描述了一些限制全腔内动脉瘤修复应用的临床情况,其中最重要的限制包括动脉瘤颈部过短且呈角状、终末主动脉狭窄、髂动脉弯曲且直径非常小或高度钙化导致难以进入,以及单侧髂动脉闭塞,后者较少见。

病例报告

在我们的病例报告中,我们介绍了一位腹主动脉瘤被认为进行经典开放手术修复风险很高的患者。我们的患者存在单侧髂动脉闭塞并伴有腹主动脉瘤,对闭塞的左髂总动脉和严重狭窄的髂外动脉段进行了经皮腔内球囊扩张,之后采用标准腔内动脉瘤修复术成功治疗了腹主动脉瘤。

结论

对该患者实施了标准的成功腔内动脉瘤修复手术,术中未出现任何并发症。同时,通过扩张闭塞的髂动脉段也确保了左髂动脉的血流。当存在诸如髂动脉闭塞等与髂动脉相关的限制时,标准腔内动脉瘤修复手术联合髂动脉血运重建的侵入性技术是一种实用且安全的治疗选择,与其他治疗选择相比,可降低手术发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7761/11994050/a97d2a95c981/ARYA-18-2382-g001.jpg

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