腹主动脉瘤腔内治疗并发症的处理策略

doi:10.3969/j.issn.1000-8535.2018.05.010

广州医药 ›› 2018, Vol. 49 ›› Issue (5): 40-43.DOI: 10.3969/j.issn.1000-8535.2018.05.010

腹主动脉瘤腔内治疗并发症的处理策略

叶东挺, 陈海生, 李彬, 张雄, 崔亚玲, 朱大量

广州市第一人民医院心脏大血管外科(广州 510180)

收稿日期:2018-05-21 出版日期:2018-09-20 发布日期:2021-11-29
通讯作者: 陈海生,E-mail:drchenhaisheng@163.com

The handling strategy of complications of abdominal aortic aneurysm after endovascular repair

YE Dongting, CHEN Haisheng, LI Bin, ZHANG Xiong, CUI Yaling, ZHU Daliang

Department of Cardiovascular Surgery, Guangzhou First People's Hospotal, Guangzhou 510180, China

Received:2018-05-21 Online:2018-09-20 Published:2021-11-29

摘要/Abstract

摘要： 目的探究和分析本组腹主动脉瘤腔内治疗病例并发症发生的原因及预防、处理策略。方法对本团队在2014年1月—2017年12月实施的37例腹主动脉瘤腔内修复手术病例进行回顾性分析。结果共有11例发生并发症,其中3例为术中I型内漏、1例术后支架移位致Ⅰ型内漏、1例术后Ⅲ型内漏、1例术中Ⅳ型内漏,全部经处理后内漏消失;术后髂动脉支架内血栓1例,经取栓后血流恢复;术后股动脉狭窄闭塞1例,经取栓并行股动脉人工血管置换后血流恢复;术后移植物反应1例,对症处理后症状消失出院;2例双侧髂内动脉栓塞致术后盆腔疼痛,随访疼痛消失,无跛行。结论腹主动脉瘤腔内修复治疗本身存在内漏、血栓、血管入路损伤、移植物反应等相关并发症。术前正确评估并严格掌握适应症以及具有成熟的操作经验,是减少并发症发生的关键。

关键词: 腹主动脉瘤, 腔内修复, 并发症, 内漏

Abstract: Objective To discuss and analyze the occurrence causes, prevention and treatment methods of complications in the endovascular repair of patients with abdominal aortic aneurysm. Methods Totally 37 cases of patients with abdominal aortic aneurysm underwent endovascular repair in our hospital from January 2014 to December 2017 were retrospectively analyzed. Results The complications were occurred in 11 cases, which including intra-operative typeⅠendoleak in 3 cases, postoperative typeⅠendoleak caused by stent displacement in 1 case; intra-operative type Ⅲ endoleak in 1 case; postoperative type Ⅳ endoleak in 1 case. all of the endoleak events disappeared after dealing. There was postoperative iliac artery stent thrombosis in 1 case, the blood flow was restored after thrombectomy; postoperative femoral artery stenosis or occlusion in 1 case, the blood flow was restored after thrombectomy and femoral artery artificial vascular replacement; postoperative host versus graft reaction in 1 case, no stent infection was found; and postoperative bilateral pelvic pain caused by internal iliac artery embolization in 2 cases, the pain disappeared during the follow-up visit, and the patients were free from lameness. Conclusion The complications related to endoleak, thrombosis, vascular approach injury and host versus graft reaction are existing with the endovascular repair itself of abdominal aortic aneurysm. The correct preoperative evaluation as well as strict control of indications and mature operational experience are the key to reduce the occurrence of complications.

Key words: Abdominal aorta aneurysm, Endovascular aneurysm repair, Complications, Endoleak

叶东挺, 陈海生, 李彬, 张雄, 崔亚玲, 朱大量. 腹主动脉瘤腔内治疗并发症的处理策略[J]. 广州医药, 2018, 49(5): 40-43.

YE Dongting, CHEN Haisheng, LI Bin, ZHANG Xiong, CUI Yaling, ZHU Daliang. The handling strategy of complications of abdominal aortic aneurysm after endovascular repair[J]. Guangzhou Medical Journal, 2018, 49(5): 40-43.

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腹主动脉瘤腔内治疗并发症的处理策略

The handling strategy of complications of abdominal aortic aneurysm after endovascular repair

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