Rückert R I, Romaniuk P, Rogalla P, Umscheid T, Stelter W J, Müller J M
Clinic of Surgery, Humboldt University Medical School (Charité), Berlin, Germany.
J Endovasc Surg. 1998 Aug;5(3):261-5. doi: 10.1583/1074-6218(1998)005<0261:AMFAAM>2.0.CO;2.
To report the successful application of a method to adjust a malpositioned bifurcated stent-graft after endovascular aortic aneurysm repair.
A 62-year-old male patient underwent endovascular repair of a 5.1-cm abdominal aortic aneurysm (AAA) with a Vanguard bifurcated stent-graft. After complete deployment of the stent-graft, the intraoperative completion angiogram disclosed unexpected occlusion of the left renal artery. Intra-aortic adjustment of the bifurcated graft was possible with a crossover guidewire, which was pulled caudally. The method worked perfectly to restore blood flow to the left renal artery. The patient is well 16 months postoperatively without any evidence of endoleak or graft migration; the left renal artery remains open.
A technique is demonstrated for intra-aortic repositioning of a bifurcated stentgraft to correct insufficient deployment. If required, this technique should be attempted before conversion to an open procedure.
报告一种在血管腔内主动脉瘤修复术后调整错位分叉型覆膜支架移植物方法的成功应用。
一名62岁男性患者接受了使用先锋分叉型覆膜支架移植物对5.1厘米腹主动脉瘤（AAA）进行的血管腔内修复。覆膜支架移植物完全展开后，术中完成血管造影显示左肾动脉意外闭塞。使用一根向尾端牵拉的交叉导丝对分叉型移植物进行主动脉内调整是可行的。该方法完美地恢复了左肾动脉的血流。患者术后16个月情况良好，无任何内漏或移植物移位的迹象；左肾动脉保持通畅。
展示了一种用于主动脉内重新定位分叉型覆膜支架移植物以纠正展开不足的技术。如有需要，在转为开放手术之前应尝试该技术。
