Iliac branched device implantation in tortuous iliac anatomy after previous open ruptured aortic aneurysm repair.
Iliac branched device implantation in tortuous iliac anatomy after previous open ruptured aortic aneurysm repair.
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先前开放式破裂主动脉瘤修复后，在曲折的髂骨解剖结构中植入髂分支装置。
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发表时间：
2012
期刊：
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通讯作者：
E. Verhoeven
中科院分区：
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作者：
G. Vourliotakis;U. Bracale;A. Sondakh;I. Tielliu;T. Prins;E. Verhoeven
本文旨在介绍在既往急诊开放性腹主动脉瘤（AAA）修复术后，髂动脉分支器械（IBD）植入一名健康的67岁男性患者，该患者髂动脉解剖结构迂曲。患者在另一家医院接受了腹主动脉瘤破裂的开放治疗。该手术因严重失血而变得复杂，这妨碍了对两个大髂动脉瘤的联合治疗。后来，患者接受了右侧髂总动脉瘤（CIAA）的支架植入术和髂内动脉（IIA）的弹簧圈栓塞术。然后，他被转介到我院治疗左侧CIAA，保留左侧IIA。IBD用于此目的。沿贯穿导丝插入放送系统，通过左腋入路插入桥接覆膜支架。使用Excluder支腿将IBD与外科移植物分支匹配。需要额外的自扩张支架来保持手术移植物的肢体开放。一年后，患者情况良好，无跛行，动脉瘤被很好地排除。由于解剖结构具有挑战性，IBD的腔内修复可能需要额外的技术技巧，但也需要备用材料才能取得成功。
The aim of this paper was to present iliac branched device (IBD) implantation in a fit 67-year-old man with tortuous iliac anatomy after previous emergent open abdominal aortic aneurysm (AAA) repair. The patient underwent open treatment for a ruptured abdominal aortic aneurysm in another hospital. The procedure was complicated by extreme blood loss which prevented concommitant treatment of two large iliac aneurysms. Later, the patient underwent stent-grafting of a right common iliac artery aneurysm (CIAA) with coil embolization of the internal iliac artery (IIA). He was then refferred to our institute for treatment of the left CIAA with preservation of the left IIA. An IBD was used to this purpose. The introduction system was inserted over a through-and-through wire, and the bridging stent-graft via a left axillary approach. An Excluder leg was used to mate the IBD with the surgical graft limb. Additional self-expanding stents were needed to keep the limbs of the surgical graft open. One year later the patient is doing well, without buttock claudication, and the aneurysm is well excluded. With challenging anatomy, endovascular repair with an IBD may require additional technical tricks but also back-up materials to achieve success.