Amahzoune B, el Mesnaoui A, Jaafar A, el Mansari O, Benjelloun A, Ammar F, Bensaïd Y
Clinique Chirurgicale D, Hôpital Ibn Sina, Rabat, Maroc.
J Mal Vasc. 1998 Oct;23(4):289-92.
Medullary ischemia is an uncommon and serious complication of subrenal aortic surgery. It generally occurs after surgery for ruptured aneurysms and second operations on the aorta. We report the case of a 29-year-old patient who had Behçet's disease with multiple arterial complications. The patient underwent emergency surgery for ruptured aneurysm of the abdominal aorta. An aorto-aortic prosthetic graft was implanted. The postoperative period was complicated by paraplegia and thrombosis of the prosthetic graft with dissection of the iliac arteries. The patient was reoperated and an aorto-bifemoral bypass was installed. After two years, the patient has recovered part of his neurological deficiency. The pathogenesis of this complication is well known, but prevention remains a challenge.
肾髓质缺血是肾下腹主动脉手术罕见且严重的并发症。它通常发生在动脉瘤破裂手术后以及主动脉二次手术之后。我们报告一例患有白塞病并伴有多种动脉并发症的29岁患者。该患者因腹主动脉瘤破裂接受了急诊手术。植入了主动脉-主动脉人工血管移植物。术后出现截瘫、人工血管移植物血栓形成并伴有髂动脉夹层。患者接受了再次手术,并安装了主动脉-双股动脉旁路。两年后,患者部分神经功能缺损有所恢复。这种并发症的发病机制已为人熟知,但预防仍然是一个挑战。