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第二种类型II内孔性腹腔动脉动脉瘤破裂的保守管理
Cheok Lam Chan1, Arvind Dhas Lee1
1Department of Vascular Surgery, Nepean Hospital, Kingswood, NSW, Australia.
Vascular
|February 14, 2026
概括
在EVAR后从II型内泄漏中破裂是罕见的. 这一案例表明,对于老年患者的某些破裂腹腔大动脉动脉瘤 (rAAA),非手术治疗可能是可能的,强调密切监测.
科学领域:
- 血管外科 血管外科
- 血管内动脉瘤修复 (EVAR) 的方法
- 腹腔大动脉动脉瘤 (AAA) 是一个
背景情况:
- 破裂腹腔大动脉动脉瘤 (rAAA) 的生存数据有限.
- 没有关于二次的rAAA存活与II型内皮细胞 (T2EL) 的文献.
- 内血管动脉瘤修复 (EVAR) 是AAA的常见治疗方法.
研究的目的:
- 报告一个与T2EL相关的rAAA的非操作性管理的罕见情况.
- 与初级rAAA相比,讨论EVAR后rAAA的自然史.
- 在特定的rAAA案例中突出非操作性管理的潜力.
主要方法:
- 一个89岁的男性病例报告,有EVAR病史和持续的T2EL,呈现rAAA.
- 计算机断层扫描血管图 (CTA) 证实了rAAA和逆皮质血瘤.
- 由于患者的年龄,并发病症和偏好,选择了非手术治疗.
主要成果:
- 患者在复苏后保持血液动力学稳定,并已出院.
- 随访CTA显示血瘤解脱与轻度动脉瘤囊扩大.
- 患者接受了选择性栓塞,并在一年后保持稳定,没有内泄.
结论:
- 在EVAR后的患者中,T2EL的破裂可能会发生.
- 非手术治疗可能是一个可行的选择选择选择血液动力学稳定的患者与rAAA后EVAR.
- 密切监测对于EVAR.之后面临风险的人群至关重要.
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