Retroperitoneal endoscopic ligation of lumbar and inferior mesenteric arteries as a treatment of persistent endoleak after endoluminal aortic aneurysm repair

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• 作者：Willem Wisselink ; Miguel A. Cuesta ; Frits J. Berends ; Fred G. van den Berg ; Jan A. Rauwerda
• 关键词：Thoracic aorta aneurysm ; aortotracheal fistula ; aortoesophageal fistula
• 刊名：Journal of Vascular Surgery
• 出版年：2000
• 出版时间：June 2000
• 年：2000
• 卷：31
• 期：6
• 页码：1240-1244
• 全文大小：3281 K

文摘

A 74-year-old man receiving long-term anticoagulation therapy for intermittent atrial fibrillation had a type II endoleak after endovascular abdominal aortic aneurysm repair. During an 8-month follow-up, the endoleak persisted, and the aneurysm failed to decrease in diameter. By means of a left flank retroperitoneal endoscopic surgical approach, the aneurysm was dissected free, and the lumbar arteries emanating from the aneurysm, as well as the inferior mesenteric artery, were ligated with titanium clips. A postoperative spiral computed tomography scan depicted one pair of unclipped lumbar arteries just proximal to the aortic bifurcation. After immediate reoperation with the same approach, complete thrombosis of the aneurysm sac was radiographically confirmed.