开窗覆膜支架腔内修复髂动脉瘤

Successful endovascular repair of isolated iliac aneurysm and reserving the internal iliac artery with fenestrated covered stent

髂动脉瘤往往与腹主动脉瘤并存,单发者少见。髂动脉位于盆腔腹膜后、位置深,开放手术难度大,而腔内修复术操作简便、创伤小,但往往以牺牲同侧髂内动脉为代价。我们应用覆膜支架开窗技术,在腔内修复髂动脉瘤的同时保留了同侧髂内动脉。

SUMMARY Isolated iliac aneurysm is rare and difficult for surgery repair because it locates in the deep pelvis. Endovascular repair is preferred currently, and internal iliac artery is generally embolized in order to avoid the endoleak. Embolization of the internal iliac artery can lead to the complications such as buttock claudication, colon ischaemia and erectile dysfunction. Therefore, the antegrade flow of internal lilac artery should be reserved. One seventy-seven-year-old male patient with isolated left common iliac aneurysm, 30 mm in diameter, was successful endovascular repaired using fenestrated covered stent. At 1-month follow up, the patient was asymptomatic. Com- puted tomography scan shows the iliac aneurysm was completely excluded, and the antegrade flow of the left common, internal and external iliac arteries were normal.