腹主动脉瘤腔内修复术后髂支闭塞治疗临床分析  

Clinical Analysis of the Treatment of Iliac Limb Occlusion Following Endovascular Abdominal Aortic Aneurysm Repair

作　　者：邵江[1] 来志超[1] 宋小军[1] 刘志丽[1] 曾嵘[1] 陈跃鑫[1] 郑月宏[1] 刘暴[1] SHAO Jiang;LAI Zhichao;SONG Xiaojun;LIU Zhili;ZENG Rong;CHEN Yuexin;ZHENG Yuehong;LIU Bao(Department of Vascular Surgery,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院血管外科,北京100730

出　　处：《中国医学科学院学报》2021年第6期917-921,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨腹主动脉瘤腔内修复术(EVAR)后髂支闭塞的原因及治疗方法。方法回顾性分析2015年1月至2020年12月本院经治的EVAR术后髂支闭塞患者的临床资料。16例(2.7%)术后并发髂支闭塞。其中6例应用外科旁路手术,9例应用腔内或杂交治疗,1例保守治疗。结果15例患者手术均获成功,随访10.6个月(6~28个月),2例杂交治疗患者因髂支再次闭塞行股股旁路手术。结论髂支闭塞多出现在EVAR术后急性期,腔内或杂交治疗重建髂支血流安全有效,可以作为髂支闭塞的首选措施,重视成因以预防为主。Objective To explore the cause and the treatment strategies of iliac limb occlusion after endovascular abdominal aortic aneurysm repair(EVAR).Methods The patients receiving EVAR in PUMC Hospital from January 2015 to December 2020 were retrospectively analyzed.Sixteen(2.7%)cases of iliac limb occlusion were identified,among which 6,9,and 1 cases underwent surgical bypass,endovascular or hybrid procedure,and conservative treatment,respectively.Results Fifteen cases were successfully treated.During the 10.6-month follow-up,2 cases receiving hybrid treatment underwent femoral-femoral bypass due to re-occlusion of the iliac limb.Conclusions Iliac limb occlusion mostly occurs in the acute phase after EVAR,and endovascular or hybrid treatment can be the first choice for iliac limb occlusion.It is suggested to focus on the risk factors for prevention.

关 键 词：腹主动脉瘤 腔内修复术 髂支闭塞 经皮机械血栓清除术 

分 类 号：R543.16[医药卫生—心血管疾病]