METHODS: A 68-year-old woman presented with one SPDAA and two IPDAAs caused by celiac axis occlusion. Aneurysmectomy for IPDAAs was difficult because of their anatomical location and shape. Therefore, we planned a two-stage hybrid therapy. The patient underwent aorto-splenic bypass and resection of the SPDAA. Follow-up CT was performed to evaluate the IPDAAs before planned endovascular embolization. Spontaneous regression of the IPDAAs and normalized PDA arcade decreased the blood flow in the PDA arcade. The patient is doing well without graft occlusion, and the IPDAAs have completely regressed 7 years after surgery.
CONCLUSIONS: Normalization of hyperinflow to the PDA arcade can lead to the regression of PDAA. Potentially, additional endovascular therapy may not be required in all cases when dilation of the PDA improves. However, more cases must be accumulated to establish criteria for predicting the risks of short- and long-term PDAA ruptures.
方法:一名68岁女性因腹腔轴闭塞而出现1例SPDAA和2例IPDAA。IPDAA的动脉瘤切除术由于其解剖位置和形状而很困难。因此,我们计划了两阶段混合疗法.患者接受了主动脉脾旁路术和SPDAA切除术。在计划的血管内栓塞之前,进行随访CT以评估IPDAA。IPDAA的自发消退和标准化的PDA拱廊降低了PDA拱廊中的血流量。病人在没有移植物阻塞的情况下做得很好,IPDAA在手术后7年完全消退。
结论:PDA拱廊的高流入标准化可导致PDAA的消退。有可能,当PDA的扩张改善时,可能并非在所有病例中都需要额外的血管内治疗.然而,必须积累更多病例,以建立预测短期和长期PDAA破裂风险的标准.