腹主动脉瘤腔内修复术后髂支闭塞的腔内处理  

Endovascular Treatment of Iliac Limb Occlusion After Endovascular Repair of Abdominal Aortic Aneurysm

作　　者：赵世录 栾景源[1] 陈瑶 冯琦琛[1] 庄金满[1] Zhao Shilu;Luan Jingyuan;Chen Yao(Department of Interventional Radiology and Vascular Surgery,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院介入血管外科,北京100191

出　　处：《中国微创外科杂志》2023年第12期913-918,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：北京新兴卫生产业发展基金(A71506-03)。

摘　　要：目的探讨腹主动脉瘤腔内修复(endovascular aneurysm repair,EVAR)术后髂支闭塞的腔内再手术效果。方法回顾性分析2018年3月~2023年3月6例EVAR术后髂支闭塞的资料。均行同侧股动脉切开Fogaty取栓、髂支球囊扩张,其中3例联合支架植入,1例联合Rotarex腘动脉取栓。结果6例髂支闭塞再通率100%(6/6)。术后中位随访时间24个月(6~48个月)。5例术后下肢缺血症状消失(Rutherford 0级),1例膝下缺血、干性坏疽(RutherfordⅢ级)。结论对于EVAR术后髂支闭塞,需仔细分析原因,选择个体化腔内治疗方案。Objective To explore the effect of endovascular re-operation on iliac limb occlusion(ILO)after endovascular aneurysm repair(EVAR).Methods Clinical data of 6 patients with ILO after EVAR from March 2018 to March 2023 were retrospectively analyzed.All the patients underwent ipsilateral femoral artery incision with Fogaty balloon thrombectomy and iliac artery balloon dilation,3 of which were combined with stent implantation and 1 of which with popliteal artery thrombectomy of Rotarex.Results The recanalization rate of the 6 patients with iliac branch occlusion was 100%(6/6).The median follow-up time was 24 months(range,6-48 months).The symptoms of lower extremity ischemia disappeared in 5 patients(Rutherford 0 grade).One patient had limb ischemia and dry gangrene(RutherfordⅢgrade).Conclusion It is necessary to carefully analyze the causes and choose personalized endovascular treatment plans for ILO after EVAR.

关 键 词：腹主动脉瘤 腔内修复术 髂支闭塞 下肢缺血 

分 类 号：R654.3[医药卫生—外科学]