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感染的支架移植和严重的动脉炎后腔粘合体栓塞的II型内孔:一个案例报告
Nathaniel Robinson1, Tiziano Tallarita2, Jason Beckermann3
1Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
AME case reports
|August 2, 2024
概括
对于II型内泄漏的横腔栓塞,存在大动脉支架移植感染的风险,这可能是难以诊断的. 早期识别和手术干预对于成功治疗这种罕见并发症至关重要.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 传染性疾病 传染性疾病
背景情况:
- 二型内漏是内血管动脉瘤修复后的常见并发症.
- 跨体栓塞是治疗II型内分泌的另一种方法,但具有潜在的风险.
- 大动脉支架移植感染是一种罕见但严重的内血管程序并发症.
研究的目的:
- 报告一例罕见的甲状腺支架移植感染病例,该病例是在II型内皮漏洞的跨栓塞后发生的.
- 要突出诊断挑战和管理策略对这种并发症.
- 讨论未来手术的风险最小化问题.
主要方法:
- 一名71岁的男性患有II型内皮漏洞,经过了用n-butyl 2-cyanoacrylate (n-BCA) 粘合剂和线圈进行跨体栓塞.
- 患者出现了暗示感染的症状,通过正子发射断层扫描和组织活检进行诊断.
- 感染的支架移植被手术扩展,大动脉用冷保存的全移植重建.
主要成果:
- 患者在栓塞后经历了腹痛和不适,有强烈炎症的证据.
- 大动脉支架移植的感染得到证实,这对治疗后炎症构成了诊断挑战.
- 成功实现了移植扩张和大动脉重建,在6个月后进行了不起眼的术后过程和专利绕道.
结论:
- 对于II型内泄漏的横腔栓塞,存在大动脉支架移植感染的风险.
- 区分感染和炎症可能很困难,这凸显了组织活检等确切的诊断方法的重要性.
- 术前优化和谨慎的手术技术对于最大限度地降低与移植移植和重建相关的风险至关重要.
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