医学
支架
肠系膜上动脉
动脉瘤
外科
放射科
血管造影
主动脉
形状记忆合金*
后备箱
栓塞
腹腔动脉
腹主动脉瘤
动脉
组合数学
生物
数学
生态学
作者
Zilun Li,Hao Yin,Mian Wang,Ridong Wu,Chenshu Liu,Chen Yao,Guangqi Chang
标识
DOI:10.1177/1526602818761663
摘要
Purpose: To report the use of the octopus endograft technique to treat a patient with a ruptured thoracoabdominal aortic aneurysm (TAAA). Case Report: A 46-year-old man was diagnosed with a contained rupture of a 9-cm type V TAAA. The presence of an occluded superior mesenteric artery (SMA), a stenotic celiac trunk, an enlarged inferior mesenteric artery (IMA), and rich collaterals with the SMA and celiac trunk made endovascular repair with the octopus endograft technique appear feasible. Two stent-grafts were overlapped in the thoracic aorta with the short limb of the distal bifurcated stent-graft about 3 cm above the celiac trunk and the long limb at the level of the renal arteries. A limb graft was introduced into the long limb of the bifurcated stent-graft and deployed with the lower end just above the orifice of the IMA. The celiac trunk was embolized. Viabahn stent-grafts were deployed through the bifurcated stent-graft limbs to revascularize the renal arteries. Completion angiography suggested free flow in the renal arteries, though the gutters around the Viabahn stent-grafts generated a moderate endoleak that persisted at 4-month follow-up. The gutters were then sealed with coil embolization, which eliminated the endoleak and induced complete thrombosis in the aneurysm sac at the 6-month follow-up. One-year computed tomography revealed significant sac shrinkage. Conclusion: The octopus endograft technique may serve as a feasible, effective, and safe treatment alternative for highly selected patients with ruptured TAAA.
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