腔内覆膜支架治疗移植肾动脉吻合口假性动脉瘤  

Endovascular repair with covered stents for the treatment of anastomotic pseudoaneurysm of transplanted renal artery

作　　者：车海杰 李笑莹[2] 桑桂凤 李鲁滨 杨牟 

机构地区：[1]山东烟台市毓磺顶医院血管外科,264000 [2]滨州医学院烟台附属医院呼吸内科

出　　处：《介入放射学杂志》2015年第11期1004-1007,共4页Journal of Interventional Radiology

摘　　要：目的探讨肾移植术后吻合口假性动脉瘤的处理。方法报道1例肾移植术后吻合口假性动脉瘤形成的病例通过血管腔内治疗成功修复,结合文献复习讨论。患者肾移植术后4个月余彩色多普勒超声检查发现移植肾动脉吻合口假性动脉瘤。通过腔内技术分别于移植肾动脉、髂外动脉内并行植入"对吻"覆膜支架成功修复动脉瘤。结果术后造影显示假性动脉瘤消失,移植肾动脉及同侧髂动脉血流通畅,随访6个月移植肾动脉血流良好。结论移植肾动脉吻合口假性动脉瘤为肾移植术后少见但严重的并发症,手术治疗效果差易发生移植肾坏死,腔内治疗创伤小,成功率高,效果确切,但是其远期结果仍需进一步随访观察。Objective To investigate the management of anastomotic pseudoaneurysms occurring after renal transplantation. Methods One case with anastomotic pseudoaneurysm occurring after renal transplantation was successfully treated by endovascular repair with covered stents, and combined with relevant medical literatures the clinical results were discussed. Color Doppler ultrasonography performed four months after renal transplantation revealed that pseudoaneurysm of transplanted renal artery was formed at anastomotic site. By using endovascular technique, the ＂kissing＂ type covered stents were implanted into the transplanted renal artery and external iliac artery respectively, and the anastomotic pseudoaneurysm was successfully repaired. Results The postoperative angiography showed that the pseudoaneurysm disappeared, and the blood flow in the transplanted renal artery and the ipsilateral iliac artery was smooth, and the renal artery blood flow remained patent during the follow-up period of 6 months. Conclusion The transplanted renal artery anastomotic pseudoaneurysms occurring after renal transplantation is a rare but severe complication. The clinical effect of surgical treatment for anastomotic pseudoaneurysm is poor and the traditional open surgery is easy to cause the necrosis of transplanted kidney. Endovascular management is minimally invasive with higher success rate and reliable effect, although its long-term results need to be further observed.

关 键 词：肾移植 动脉瘤 假性 血管腔内治疗 覆膜支架 

分 类 号：R699.2[医药卫生—泌尿科学]