PDF(Pubmed)
Abstract：
BACKGROUND: Conventional graft replacement for a juxtarenal abdominal aortic aneurysm (JRAAA) remains challenging for high-risk patients since it often requires the reconstruction of some visceral arteries.
METHODS: A 76-year-old woman was diagnosed with an 87 × 48 mm saccular JRAAA. Open graft replacement was contraindicated because of frailty and a past history of trans-thoracoabdominal esophagectomy. Chimney endovascular aortic repair (ChEVAR) with three chimney endografts was successfully performed without any endoleaks, and each visceral circulation was kept intact. The patient was discharged uneventfully on postoperative day 8. Significant shrinkage of the aneurysmal sac and preservation of flow through each chimney graft were observed on computed tomography 6 months postoperatively, with no significant increase in serum creatinine levels on laboratory testing.
CONCLUSIONS: ChEVAR can be a useful surgical option instead of conventional operations, especially for high-risk cases.
METHODS: A 76-year-old woman was diagnosed with an 87 × 48 mm saccular JRAAA. Open graft replacement was contraindicated because of frailty and a past history of trans-thoracoabdominal esophagectomy. Chimney endovascular aortic repair (ChEVAR) with three chimney endografts was successfully performed without any endoleaks, and each visceral circulation was kept intact. The patient was discharged uneventfully on postoperative day 8. Significant shrinkage of the aneurysmal sac and preservation of flow through each chimney graft were observed on computed tomography 6 months postoperatively, with no significant increase in serum creatinine levels on laboratory testing.
CONCLUSIONS: ChEVAR can be a useful surgical option instead of conventional operations, especially for high-risk cases.
摘要：
背景：对于高危患者来说，肾近腹主动脉瘤（JRAAA）的常规移植物置换仍然具有挑战性，因为它通常需要重建一些内脏动脉。
方法：一名76岁女性被诊断患有87×48mm的JRAAA囊状。由于虚弱和过去的经胸腹食管切除术史，禁忌进行开放式移植物置换。成功进行了带有三个烟囱内移植物的烟囱腔内主动脉修复术（ChEVAR），没有任何内漏。每个内脏循环都保持完整。患者在术后第8天顺利出院。术后6个月在计算机断层扫描中观察到动脉瘤囊的明显收缩和通过每个烟囱移植物的流量的保留。在实验室检测中血清肌酐水平没有显着增加。
结论：ChEVAR可以是一种有用的手术选择，而不是常规手术，尤其是高危病例。
方法：一名76岁女性被诊断患有87×48mm的JRAAA囊状。由于虚弱和过去的经胸腹食管切除术史，禁忌进行开放式移植物置换。成功进行了带有三个烟囱内移植物的烟囱腔内主动脉修复术（ChEVAR），没有任何内漏。每个内脏循环都保持完整。患者在术后第8天顺利出院。术后6个月在计算机断层扫描中观察到动脉瘤囊的明显收缩和通过每个烟囱移植物的流量的保留。在实验室检测中血清肌酐水平没有显着增加。
结论：ChEVAR可以是一种有用的手术选择，而不是常规手术，尤其是高危病例。
