1例腔内治疗腹主动脉瘤破裂合并髂静脉瘘

One Case of Endovascular Treatment of Ruptured Abdominal Aortic Aneurysm Associated with Iliac Venous Fistula

本文报道了1例腔内治疗腹主动脉瘤破裂合并髂静脉瘘患者,术中置入分叉型覆膜支架,但术后造影仍有明显渗漏,确定内漏并非Ⅰ型内漏,而是支架膜网孔渗漏,即Ⅳ型内漏。对于该例患者支架膜漏的处理,选择在瘘口放置房缺封堵器,但因瘘口处血管壁形态不平整,致使封闭效果不佳。最终,支架内再放置覆膜支架,使腹主动脉瘤腔内的支架层数最少有二层重叠,最终使膜漏明显减少直至完全消失。

This paper reports 1 case of endovascular treatment for the patient with ruptured abdominal aortic aneurysm associated with iliac veinous fistula, which was intraoperative placed into bifurcated stent grafts, but angiography still has obvious leakage after operation, internal leakage does not determine the type I endoleak, but the stent mesh leakage, namely type IV leakage. For the treatment of patients with stent membrane leakage, fistula placed in the room lack of occlusion device, but the fistula at the vascular wall morphology is not smooth, resulting in poor closure