自制髂动脉分支装置治疗腹主动脉瘤腔内修复术后髂动脉瘤1例
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摘要
<正>髂动脉分支装置(iliac branch device,IBD)是专为髂动脉分叉设计的分支支架,为主-髂动脉瘤、孤立性髂动脉瘤腔内治疗时重建髂内动脉血流的理想解决方案。北京大学人民医院血管外科利用自制的一枚IBD,成功治疗腹主动脉瘤腔内修复术(endovascular aneurysm repair,EVAR)后髂动脉瘤1例,其设计及植入较既往报道[1-3]均有独到之处,现
An involved internal iliac artery is usually embolized when performing endovascular aneurysm repair for aortoiliac or isolated iliac artery aneurysm. This can lead to complications such as buttock claudication,colon ischaemia and erectile dysfunction. Iliac branch device( IBD) is an endograft designed specifically for iliac bifurcation to preserve internal iliac flow. It was performed with high technical success rates and encouraging mid-term patency. Here we report a case of right iliac aneurysm developed3 years after endovascular aneurysm repair for an aortoiliac aneurysm,with the patient's left internal artery been sacrificed then. Using a handmade IBD,we excluded the aneurysm without occlusion of the ipsilateral internal iliac artery or any type of endoleak. Both the design and deployment of this IBD are distinctive that we would like to share our experience with all the colleagues.
An involved internal iliac artery is usually embolized when performing endovascular aneurysm repair for aortoiliac or isolated iliac artery aneurysm. This can lead to complications such as buttock claudication,colon ischaemia and erectile dysfunction. Iliac branch device( IBD) is an endograft designed specifically for iliac bifurcation to preserve internal iliac flow. It was performed with high technical success rates and encouraging mid-term patency. Here we report a case of right iliac aneurysm developed3 years after endovascular aneurysm repair for an aortoiliac aneurysm,with the patient's left internal artery been sacrificed then. Using a handmade IBD,we excluded the aneurysm without occlusion of the ipsilateral internal iliac artery or any type of endoleak. Both the design and deployment of this IBD are distinctive that we would like to share our experience with all the colleagues.
引文
[1]李晓强,桑宏飞,孟庆友,等.带髂内分支支架的腔内隔绝术治疗腹主动脉瘤伴双髂动脉瘤[J].中国血管外科杂志:电子版,2012,4(3):150-152.
[2]栾景源,李选,冯琦琛,等.开窗覆膜支架腔内修复髂动脉瘤[J].北京大学学报:医学版,2012,44(3):489-491.
[3]马晓辉,郭伟,刘小平,等.定制髂动脉分支装置腔内重建髂内动脉的临床分析[J].中华外科杂志,2013,51(10):940-942.
[4]Karch LA,Hodgson KJ,Mattos MA,et al.Adverse consequences of internal iliac artery occlusion during endovascular repair of abdominal aortic aneurysms[J].J Vasc Surg,2000,32(4):676-683.
[5]Karthikesalingam A,Hinchliffe RJ,Holt PJ,et al.Endovascular aneurysm repair with preservation of the internal iliac artery using the iliac branch graft device[J].Eur J Vasc Endovasc Surg,2010,39(3):285-294.
[6]Lee CW,Kaufman JA,Fan CM,et al.Clinical outcome of internal iliac artery occlusions during endovascular treatment of aortoiliac aneurysmal diseases[J].J Vasc Interv Radiol,2000,11(5):567-571.
[7]Razavi MK,De Groot M,Olcott CR,et al.Internal iliac artery embolization in the stent-graft treatment of aortoiliac aneurysms:analysis of outcomes and complications[J].J Vasc Interv Radiol,2000,11(5):561-566.
[8]Sandhu RS,Pipinos I I.Isolated iliac artery aneurysms[J].Semin Vasc Surg,2005,18(4):209-215.
[9]Urayama H,Ohtake H,Katada S,et al.Exclusion of internal iliac arterial aneurysm concomitant with abdominal aortic aneurysm repair[J].J Cardiovasc Surg(Torino),1999,40(2):243-247.
[10]钱水贤,张慈.孤立性髂动脉瘤的临床诊治现状[J].中国血管外科杂志:电子版,2012,4(3):143-145.
[11]Lobato AC.Sandwich technique for aortoiliac aneurysms extending to the internal iliac artery or isolated common/internal iliac artery aneurysms:a new endovascular approach to preserve pelvic circulation[J].J Endovasc Ther,2011,18(1):106-111.
[12]Kritpracha B,Pigott JP,Russell TE,et al.Bell-bottom aortoiliac endografts:an alternative that preserves pelvic blood flow[J].J Vasc Surg,2002,35(5):874-881.
[2]栾景源,李选,冯琦琛,等.开窗覆膜支架腔内修复髂动脉瘤[J].北京大学学报:医学版,2012,44(3):489-491.
[3]马晓辉,郭伟,刘小平,等.定制髂动脉分支装置腔内重建髂内动脉的临床分析[J].中华外科杂志,2013,51(10):940-942.
[4]Karch LA,Hodgson KJ,Mattos MA,et al.Adverse consequences of internal iliac artery occlusion during endovascular repair of abdominal aortic aneurysms[J].J Vasc Surg,2000,32(4):676-683.
[5]Karthikesalingam A,Hinchliffe RJ,Holt PJ,et al.Endovascular aneurysm repair with preservation of the internal iliac artery using the iliac branch graft device[J].Eur J Vasc Endovasc Surg,2010,39(3):285-294.
[6]Lee CW,Kaufman JA,Fan CM,et al.Clinical outcome of internal iliac artery occlusions during endovascular treatment of aortoiliac aneurysmal diseases[J].J Vasc Interv Radiol,2000,11(5):567-571.
[7]Razavi MK,De Groot M,Olcott CR,et al.Internal iliac artery embolization in the stent-graft treatment of aortoiliac aneurysms:analysis of outcomes and complications[J].J Vasc Interv Radiol,2000,11(5):561-566.
[8]Sandhu RS,Pipinos I I.Isolated iliac artery aneurysms[J].Semin Vasc Surg,2005,18(4):209-215.
[9]Urayama H,Ohtake H,Katada S,et al.Exclusion of internal iliac arterial aneurysm concomitant with abdominal aortic aneurysm repair[J].J Cardiovasc Surg(Torino),1999,40(2):243-247.
[10]钱水贤,张慈.孤立性髂动脉瘤的临床诊治现状[J].中国血管外科杂志:电子版,2012,4(3):143-145.
[11]Lobato AC.Sandwich technique for aortoiliac aneurysms extending to the internal iliac artery or isolated common/internal iliac artery aneurysms:a new endovascular approach to preserve pelvic circulation[J].J Endovasc Ther,2011,18(1):106-111.
[12]Kritpracha B,Pigott JP,Russell TE,et al.Bell-bottom aortoiliac endografts:an alternative that preserves pelvic blood flow[J].J Vasc Surg,2002,35(5):874-881.