Background：To evaluate the feasibility of a new surgeon-modified iliac branch device （IBD） technique to maintain pelvic perfusion in the management of common iliac artery （CIA） aneurysm during endovascular aneury...Background：To evaluate the feasibility of a new surgeon-modified iliac branch device （IBD） technique to maintain pelvic perfusion in the management of common iliac artery （CIA） aneurysm during endovascular aneurysm repair （EVAR）.Methods：From January 2011 to December 2013,a new surgeon-modified IBD technique was performed in department of vascular surgery of Peking Union Medical College Hospital in five patients treated for CIA aneurysm with or without abdominal aortic aneurysm.A stent-graft limb was initially deployed in vitro,anastomosed with vascular graft,creating a modified IBD reloaded into a larger sheath,with or without a guidewire preloaded into the side branch.The reloaded IBD was then placed in the iliac artery,with a covered stent bridging internal iliac artery and the branch.Finally,a bifurcated stent-graft was deployed,and a limb device was used to connect the main body and IBD.Results：Technical successes were obtained in all patients.The mean follow-up length was 24 months （range：6-38 months）.All grafts remained patent without any sign of endoleaks.There were no aneurysm ruptures,deaths,or other complications related to pelvic flow.Conclusions：Using the surgeon-modified IBD to preserve pelvic flow is a feasible endovascular technique and an appealing solution for personalized treatment of CIA aneurysm during EVAR.展开更多
目的探索常规多普勒超声辅助腹主动脉瘤腔内覆膜支架修复术(EVAR)的技术可行性和有效性。方法对1例造影剂肾功能受损的腹主动脉瘤合并左侧髂总动脉瘤和左侧髂内动脉瘤患者,行无造影剂的术中常规超声辅助EVAR和左侧髂内动脉瘤栓塞术,总...目的探索常规多普勒超声辅助腹主动脉瘤腔内覆膜支架修复术(EVAR)的技术可行性和有效性。方法对1例造影剂肾功能受损的腹主动脉瘤合并左侧髂总动脉瘤和左侧髂内动脉瘤患者,行无造影剂的术中常规超声辅助EVAR和左侧髂内动脉瘤栓塞术,总结该患者的临床资料。结果透视下借助常规超声辅助,主动脉支架释放成功,左侧髂内动脉瘤弹簧圈栓塞成功,腹主动脉瘤及左侧髂总动脉瘤隔绝成功。术中超声显示来自肠系膜下动脉的Ⅱ型内漏,右侧髂支Ⅰb型内漏。患者的手术时间为120 min,术中出血量为20 m L。术后1周常规彩超显示,右侧髂支Ⅰb型内漏消失,来自肠系膜下动脉的Ⅱ型内漏仍然存在,于术后1周顺利出院。等待后续随访结果。结论常规超声辅助EVAR治疗解剖条件良好的腹主动脉瘤时,能清楚显示近远端锚定区域以及内漏情况,尤其适合存在碘造影剂禁忌的患者。展开更多
文摘Background：To evaluate the feasibility of a new surgeon-modified iliac branch device （IBD） technique to maintain pelvic perfusion in the management of common iliac artery （CIA） aneurysm during endovascular aneurysm repair （EVAR）.Methods：From January 2011 to December 2013,a new surgeon-modified IBD technique was performed in department of vascular surgery of Peking Union Medical College Hospital in five patients treated for CIA aneurysm with or without abdominal aortic aneurysm.A stent-graft limb was initially deployed in vitro,anastomosed with vascular graft,creating a modified IBD reloaded into a larger sheath,with or without a guidewire preloaded into the side branch.The reloaded IBD was then placed in the iliac artery,with a covered stent bridging internal iliac artery and the branch.Finally,a bifurcated stent-graft was deployed,and a limb device was used to connect the main body and IBD.Results：Technical successes were obtained in all patients.The mean follow-up length was 24 months （range：6-38 months）.All grafts remained patent without any sign of endoleaks.There were no aneurysm ruptures,deaths,or other complications related to pelvic flow.Conclusions：Using the surgeon-modified IBD to preserve pelvic flow is a feasible endovascular technique and an appealing solution for personalized treatment of CIA aneurysm during EVAR.
文摘目的探索常规多普勒超声辅助腹主动脉瘤腔内覆膜支架修复术(EVAR)的技术可行性和有效性。方法对1例造影剂肾功能受损的腹主动脉瘤合并左侧髂总动脉瘤和左侧髂内动脉瘤患者,行无造影剂的术中常规超声辅助EVAR和左侧髂内动脉瘤栓塞术,总结该患者的临床资料。结果透视下借助常规超声辅助,主动脉支架释放成功,左侧髂内动脉瘤弹簧圈栓塞成功,腹主动脉瘤及左侧髂总动脉瘤隔绝成功。术中超声显示来自肠系膜下动脉的Ⅱ型内漏,右侧髂支Ⅰb型内漏。患者的手术时间为120 min,术中出血量为20 m L。术后1周常规彩超显示,右侧髂支Ⅰb型内漏消失,来自肠系膜下动脉的Ⅱ型内漏仍然存在,于术后1周顺利出院。等待后续随访结果。结论常规超声辅助EVAR治疗解剖条件良好的腹主动脉瘤时,能清楚显示近远端锚定区域以及内漏情况,尤其适合存在碘造影剂禁忌的患者。
