腹主动脉瘤腔内隔绝术后Ⅰ型内漏的治疗(附3例报告)

Treatment of typeⅠendoleak after endovascular aneurysm repair for abdominal aortic aneurysms: a report of 3 cases

目的总结腹主动脉瘤腔内隔绝术后Ⅰ型内漏再行开放手术的治疗经验。方法回顾性分析本院2013年至2014年救治的3例腹主动脉瘤腔内隔绝术后Ⅰ型内漏再行开放手术治疗的临床资料,3例均采用腹主动脉瘤切除+支架取出+人造血管置换术,术后均给予相应积极支持治疗。结果 3例均手术成功,术后48小时内死亡1例,痊愈2例。结论腹主动脉瘤隔绝术后出现I型内漏、破裂、血栓闭塞等原因再次急诊入院的患者,介入治疗不能解决问题时,应果断采取传统开放手术,可取得较好的治疗效果。

Objective To discuss experiences of open repair（OR） for the patients after endovascular aneurysm repair（EVAR） because of endoleak, rupture and thromboembolism. Methods Clinical data of 3abdominal aortic aneurysm（AAA）patients after EVAR,undergoing OR,from 2013 to 2014 were retrospectively analyzed. All of 3 cases received fluid therapy throughout the process of AAA excision, graft removal and artificial blood vessel replacement, as well as postoperative supportive treatment. Results Of 3 cases, 2cases recovered and 1 case died 48 hours after surgery. Conclusions For the patients after EVAR who is hospitalized again because of endoleak, rupture and thromboembolism, though EVAR brings less surgical trauma, shorter hospital stay, traditional OR should be taken in certain conditions for better rescue.