四开窗主动脉支架植入联合双侧髂动脉支架 植入术治疗复杂性腹主动脉瘤：一例报告

Quadruple Fenestration Aortic Stent Implantation Combined with Bilateral Iliac Artery Stent Implantation for Complex Abdominal Aortic Aneurysm: One Case Report

摘要: 腹主动脉瘤是一种常见的临床疾病，需要及时有效的治疗以避免破裂。对于复杂的腹主动脉瘤患者，外科医生必须谨慎选择合适的修复方法并评估长期手术预后。本病例报告描述了一位82岁男性患者，因腹主动脉瘤腹痛入院。胸腹主动脉CTA显示，该动脉瘤累及多达四条内脏分支血管，无瘤颈，且血管壁上附着大量血栓，部分血栓紧邻左侧肾动脉，并伴有双侧髂总动脉及多个内脏区分支血管狭窄。本病例中，我们的团队运用三维技术模拟了动脉瘤的空间结构，并对患者的病情进行了综合评估。最终，我们决定对该患者实施四开窗腹主动脉支架植入术和胸主动脉瘤覆膜支架腔内修复术，同时行双侧髂动脉支架植入术及球囊扩张重建术。这是一种创新性的手术方法。手术非常成功，患者术后恢复良好。

Abstract: Abdominal aortic aneurysm is a common clinical condition requiring timely and effective treatment to prevent rupture. For patients with complex abdominal aortic aneurysms, surgeons must carefully select the appropriate repair method and assess long-term surgical prognosis. This case report describes an 82-year-old male patient admitted with abdominal pain due to an abdominal aortic aneurysm. Thoracoabdominal aortic CTA revealed that the aneurysm involved up to four visceral branches, had no neck, and contained numerous thrombi attached to the vessel walls, some adjacent to the left renal artery, along with stenosis of both common iliac arteries and multiple visceral branch vessels. In this case, our team used 3D technology to simulate the spatial structure of the aneurysm and comprehensively assessed the patient's condition. Ultimately, we decided to perform a four-fenestration abdominal aortic stenting and endovascular repair of the thoracic aortic aneurysm with a covered stent, along with bilateral iliac artery stenting and balloon dilation and reconstruction. This was an innovative surgical approach. The surgery was highly successful, and the patient recovered well postoperatively.