JAMA surgery · 2014
Surgeon-modified fenestrated endograft to treat ruptured juxtarenal aneurysm.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pisimisis George T, Kougias Panagiotis, Barshes Neal R, Bechara Carlos F
Аннотация
IMPORTANCE: No endovascular devices are commercially available in the United States to treat high-surgical risk patients with aneurysms extending to visceral arteries. Treatment options are even further limited for symptomatic patients in need of urgent treatment.
OBJECTIVE: To describe a successful urgent endovascular repair of a juxtarenal abdominal aortic aneurysm with contained rupture.
DESIGN, SETTING, AND PARTICIPANTS: A hybrid suite using a surgeon-modified fenestrated endovascular graft and advanced 3-dimensional imaging workstation. The patient was an 82-year-old veteran taking clopidogrel and aspirin for coronary stents with significant cardiopulmonary comorbidities including multiple prior abdominal surgeries and a single functional left kidney.
INTERVENTION: Surgeon-modified fenestrated endovascular aortic aneurysm repair.
MAIN OUTCOMES AND MEASURES: Clinical, laboratory, and radiographic improvement.
RESULTS: The patient was discharged 5 days after an uneventful postoperative course. On short-term follow-up, the patient had an early return to his baseline functional status. The excluded aneurysm sac shrank with patent visceral branches and there was an absence of endoleak on 3-month and 6-month surveillance computed tomography angiography.
CONCLUSIONS AND RELEVANCE: Surgeon-modified fenestrated stent grafts may be a viable option for selected high-surgical risk patients with symptomatic complex abdominal aortic aneurysms.
OBJECTIVE: To describe a successful urgent endovascular repair of a juxtarenal abdominal aortic aneurysm with contained rupture.
DESIGN, SETTING, AND PARTICIPANTS: A hybrid suite using a surgeon-modified fenestrated endovascular graft and advanced 3-dimensional imaging workstation. The patient was an 82-year-old veteran taking clopidogrel and aspirin for coronary stents with significant cardiopulmonary comorbidities including multiple prior abdominal surgeries and a single functional left kidney.
INTERVENTION: Surgeon-modified fenestrated endovascular aortic aneurysm repair.
MAIN OUTCOMES AND MEASURES: Clinical, laboratory, and radiographic improvement.
RESULTS: The patient was discharged 5 days after an uneventful postoperative course. On short-term follow-up, the patient had an early return to his baseline functional status. The excluded aneurysm sac shrank with patent visceral branches and there was an absence of endoleak on 3-month and 6-month surveillance computed tomography angiography.
CONCLUSIONS AND RELEVANCE: Surgeon-modified fenestrated stent grafts may be a viable option for selected high-surgical risk patients with symptomatic complex abdominal aortic aneurysms.
Предметные рубрики MeSH
Aged, 80 and overAortic Aneurysm, AbdominalAortic RuptureBlood Vessel ProsthesisEmergenciesEndovascular ProceduresHumansImage Interpretation, Computer-AssistedImaging, Three-DimensionalKidney Failure, ChronicMalePatient TransferPostoperative ComplicationsProsthesis DesignProsthesis FittingRenal Artery ObstructionReoperationTomography, X-Ray Computed