腹主动脉瘤腔内隔绝术中髂动脉的处理  

Management of iliac arteries in endovascular graft exclusion of abdominal aortic aneurysm

作　　者：何玉祥[1] 种振岳[1] 王默[1] 高培显[1] 韩宗霖[1] 刘洋[1] 金星[1] 

机构地区：[1]山东大学附属省立医院血管外科,山东济南250021

出　　处：《外科理论与实践》2011年第2期133-136,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:总结腹主动脉瘤(AAA)行腔内隔绝术时髂动脉的处理方式。方法:2004年7月至2010年11月共对43例瘤体累及单侧或双侧髂动脉分叉的AAA行腔内隔绝术,其中单侧髂动脉分叉受累27例,双侧髂动脉分叉受累16例。根据髂动脉病变情况,分别采取髂内动脉单纯覆盖、髂内动脉栓塞后覆盖、髂动脉外环结扎、一侧髂内动脉重建等不同的处理方法。结果:所有病例均操作成功,手术结束时无Ⅰ型内漏存在。术后出现臀部间歇性跛行6例(14.0%),便血1例(2.3%),无病例发生臀部或会阴部皮肤坏死、肠坏死及死亡。结论:术中避免同时封闭双侧髂内动脉,尽量保留一侧髂内动脉是很重要的。Objective To summarize our experiences of management for iliac artery in endovascular graft exclusion（EVGE） of abdominal aortic aneurysm（AAA）.Methods From July 2004 to November 2010,EVGE were performed in 43 patients with AAAs,including 27 cases involving unilateral and 16 cases of bilateral iliac bifurcations.Various techniques including simple coverage by stent-graft,embolization of the internal iliac artery trunk combined with stent-graft covering,ligation of common iliac artery,reconstruction of the internal iliac artery and combination of the above techniques were applied according to the different conditions of the iliac arterial system involved.Results The procedures were all technically successful in 43 patients without the occurrence of type Ⅰ endoleakage.Claudication due to gluteus ischemia occurred in 6 cases（14.0%） and bloody stool in 1 case（2.3%）;no patient developed buttock,perineal region,and colorectal necrosis;and no patient died.Conclusions It is important to preserve the patency of one of the internal iliac arteries and avoid occlusion of both internal iliac arteries in EVGE of AAA.

关 键 词：腹主动脉瘤 腔内隔绝术 髂动脉 

分 类 号：R654.3[医药卫生—外科学]