孤立性髂动脉瘤的外科及腔内治疗

Surgical and endovascular treatment for isolated iliac artery aneurysm

目的总结孤立性髂动脉瘤的治疗经验。方法回顾性分析收治的8例孤立性髂动脉瘤患者的临床资料。4例患者接受髂动脉瘤切除,人工血管重建手术;4例高龄且合并症较多的患者接受腔内支架修复术。结果所有患者治疗均获成功,1例接受腔内治疗患者术后出现腹膜后脓肿,经积极抗感染及手术引流后治愈;余7例未出现并发症。术后随访3个月至2年,所有患者存活良好,无复发。结论外科开放手术及腔内手术均可以安全有效地治疗孤立性髂动脉瘤,临床上需根据患者具体情况选择合理的治疗方式,对于高龄且合并症较多的高危患者应首选腔内手术治疗。

Objective To summarize the experiences in surgical and endovascular treatment for isolated iliac artery aneurysm（IAA）.Methods The clinical data of 8 patients with isolated IAA treated in our department from January 2007 to May 2010,that included 4 patients who underwent open surgical repair after aneurysm resection and 4 aged patients with several comorbidities who underwent endovascular stent-graft placement,were retrospectively analyzed.Results All the 8 cases were treated successfully but 1 case of endovascular repair developed retroperitoneal abscess after operation that was cured by surgical drainage and anti-infectious therapy;no complications occurred in the other 7 cases.Follow-up periods ranged from 3 months to 2 years.All the patients survived well without recurrence.Conclusions Both open surgical and endovascular repair are safe and effective for IAA,and the selection of proper treatment in clinical practice is based on the specific circumstances of the patients.For the aged patients,who usually have several concomitant diseases,endovascular repair should be taken as the first option.