不使用造影剂的腹主动脉瘤腔内隔绝术

Non-contrasted endovascular exclusion for abdominal aortic aneurysm

目的 探讨一种不使用造影剂的腹主动脉瘤 (AAA)腔内隔绝术 (EVE) ,治疗合并肾功能不全的AAA患者。方法 对 3例合并肾功能不全的AAA患者在不使用造影剂条件下实施AAAEVE ,并对术前评估内容进行分析。结果 3例患者手术均获成功 ,2例采用分叉型移植物 ,1例采用直型移植物。术后随访结果表明 ,动脉瘤被完全隔绝 ,无内漏 ,瘤腔内血栓形成 ;移植物内血流通畅 ,周围无异常血流。结论 选择近端瘤颈较长的患者 ,术前对肾动脉及髂内动脉开口位置等指标进行准确评估 ,不使用造影剂同样可以完成AAAEVE。

Objective To discuss the endovascular exclusion without using contrast for abdominal aortic aneurysm patients with renal disfunction. Methods We performed endovascular exclusion for abdominal aortic aneurysm in 3 cases associated with renal disfunction. The evaluations of related diagnostic informations including images were reviewed before operation. Results The operations were successful in all 3 cases with 2 bifurcation grafts and 1 straight graft. After 1 to 3 months follow up through colour ultrasound, we found the aneurysms were excluded completely without endoleak, and occluded with thrombosis. The bloodflow in the graft was patent without abnormal peripheral circulation. Conclusions Endovascular exclusion can be successfully performed on the abdominal aortic aneurysm with long aneurysm neck. Preoperative evaluation is important for the localigation of renal artery and hypogastric artery.