腹主动脉腔内修复术后II型内漏的栓塞治疗：附3例报告

目的:探讨腹主动脉腔内修复术(EVAR)后Ⅱ型内漏的治疗方法。方法:回顾性分析2011—2016年中南大学湘雅医院血管外科治疗的3例EVAR术后比较严重的Ⅱ型内漏患者的临床资料,1例胸腹主动脉瘤行杂交手术(开放手术重建内脏血管+EVAR)后瘤体继续增大,检查发现为腹腔干动脉反流性内漏;另外2例均为腹主动脉瘤行EVAR术后肠系膜下动脉反流性内漏。结果:腹腔干动脉反流性内漏患者用Interlock可解脱弹簧圈系统栓塞,另外2例采用普通弹簧圈栓塞。3例栓塞均获得成功,内漏消失。结论:EVAR术后Ⅱ型内漏采用不同的入路栓塞是行之有效的方法。

Embolization for type II endoleak after endovascular abdominal aortic aneurysm repair: a report of 3 cases

Objective: To investigate the treatment method for type II endoleak after endovascular abdominal aortic aneurysm repair (EVAR). Methods: The clinical data of 3 patients with relatively severe type II endoleak after EVAR treated in the Department of Vascular Surgery of Xiangya Hospital from 2011 to 2016 were retrospectively analyzed. Of the patients, one case with a continuous enlargement of the aneurysmal sac after hybrid operation (reconstruction of the visceral vessels plus EVAR) for thoracoabdominal aortic aneurysm, a retrograde endoleak from the celiac axis was found by CTA examination; the other two cases had a retrograde endoleak from inferior mesenteric artery after EVAR for abdominal aortic aneurysm. Results: The patient with retrograde endoleak from the celiac axis was treated with Interlock detachable coil embolization, and the other two patients were treated with conventional coil embolization. Embolization was successfully performed and the endoleak disappeared in the 3 patients. Conclusion: Embolization using different approaches is an effective method for type II endoleak after EVAR.