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分离式髂支器械鼻锥的保护性取出

Protected retrieval of a detached iliac branch device nosecone.

作者信息

Pasquetti Leonardo, Pasqui Edoardo, Galzerano Giuseppe, Gargiulo Bruno, Molino Cecilia, de Donato Gianmarco

机构信息

Department of Medicine, Surgery and Neuroscience, Università Degli Studi di Siena, Siena, Italy.

出版信息

J Vasc Surg Cases Innov Tech. 2025 May 31;11(4):101835. doi: 10.1016/j.jvscit.2025.101835. eCollection 2025 Aug.

DOI:10.1016/j.jvscit.2025.101835
PMID:40521386
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12163144/
Abstract

The detachment of components of endovascular devices is a rare but potentially harmful complication. This report describes a clinical case of nosecone detachment from an iliac branch device delivery system during an aortoiliac aneurysm exclusion in a 73-year-old male patient. After correct deployment, the iliac branch device nosecone detached during the removal of the delivery system. The guidewire was snared from the contralateral side, and two long sheaths were advanced to trap and protect the fractured piece, ensuring nice alignment and enabling its safe removal. This case highlights key strategies for managing serious complications encountered during endovascular aortic repair.

摘要

血管内装置部件的分离是一种罕见但可能有害的并发症。本报告描述了一名73岁男性患者在腹主动脉瘤排除手术过程中，髂支装置输送系统的鼻锥发生分离的临床病例。在正确植入后，输送系统移除过程中髂支装置鼻锥分离。从对侧圈套住导丝，并推进两个长鞘管以捕获和保护断裂部件，确保良好对齐并使其能够安全移除。该病例突出了处理血管内主动脉修复过程中遇到的严重并发症的关键策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/74935d00ed3f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/d9815a8eb0bf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/ca33dddfe5da/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/6d3a85f40c9c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/1e02623f1726/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/74935d00ed3f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/d9815a8eb0bf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/ca33dddfe5da/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/6d3a85f40c9c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/1e02623f1726/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f638/12163144/74935d00ed3f/gr5.jpg

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本文引用的文献

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Surg Pract Sci. 2022 Oct 25;11:100141. doi: 10.1016/j.sipas.2022.100141. eCollection 2022 Dec.
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Systematic review and meta-analysis of incidence, indications, and outcomes of early open conversions after EVAR for abdominal aortic aneurysms.系统回顾和荟萃分析腹主动脉瘤血管内修复术后早期开放转换的发生率、适应证和结局。
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Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms.
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An unusual cause of failure in Zenith Alpha Abdominal endograft.Zenith Alpha 腹主动脉覆膜支架内漏的一个不常见原因。
Eur J Med Res. 2022 Mar 2;27(1):32. doi: 10.1186/s40001-022-00656-5.
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Zenith AAA endovascular graft suprarenal bare metal stent separation with graft migration and type IA endoleak.覆膜支架超肾区裸金属支架分离伴移植物迁移和 1A 型内漏。
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A preliminary analysis of late structural failures of the Navion stent graft in the treatment of descending thoracic aortic aneurysms.用于治疗降主动脉瘤的Navion支架移植物晚期结构失效的初步分析。
J Vasc Surg. 2021 Oct;74(4):1125-1134.e2. doi: 10.1016/j.jvs.2021.04.018. Epub 2021 Apr 20.
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Emergent open conversion for stent-graft deployment failure in a ruptured thoracic aneurysm.破裂性胸主动脉瘤覆膜支架置入失败后的急诊开放转换术
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