맞춤형 스텐트-그라프트를 이용한 감염성 복부 가성 대동맥류의 혈관 내 치료: 증례 보고

A Case Report of the Endovascular Treatment of Mycotic Abdominal Aortic Pseudoaneurysms Using a Customized Stent-Graft

  • 정서인 (화순전남대학교병원 영상의학과) ;
  • 정혜두 (전남대학교병원 영상의학과) ;
  • 임재훈 (전남대학교병원 영상의학과) ;
  • 임남열 (화순전남대학교병원 영상의학과) ;
  • 장남규 (화순전남대학교병원 영상의학과) ;
  • 김재규 (전남대학교병원 영상의학과) ;
  • 최수진나 (전남대학교병원 외과)
  • Jeong, Seo-In (Department of Radiology, Chonnam National University Hwasun Hospital) ;
  • Jung, Hye-Doo (Department of Radiology, Chonnam National University Hospital) ;
  • Lim, Jae-Hoon (Department of Radiology, Chonnam National University Hospital) ;
  • Yim, Nam-Yeol (Department of Radiology, Chonnam National University Hwasun Hospital) ;
  • Chang, Nam-Kyu (Department of Radiology, Chonnam National University Hwasun Hospital) ;
  • Kim, Jae-Kyu (Department of Radiology, Chonnam National University Hospital) ;
  • Choi, Soo-Jin-Na (Department of Surgery, Chonnam National University Hospital)
  • 발행 : 2011.09.01

초록

복부 대동맥의 주요 혈관 기시부 주위에 발생한 대동맥류는 해부학적인 이유로 혈관 내 치료보다는 수술로 치료되었다. 최근에는 맞춤형 스텐트-그라프트를 이용하여 주요 혈관 기시부 주위에 위치한 대동맥류의 치료가 시도되고 있다. 저자들은 감염에 의해 발생한 상장간막동맥 기시부의 복부 가성 대동맥류를 맞춤형 스텐트-그라프트로 성공적인 치료를 하였기에 이를 보고하고자 한다.

Abdominal aortic aneurysms located around the major branch of the aorta were treated surgically rather than by endovascular treatment due to the complex anatomy. Recently, the treatment modality evolved towards a customized stent-graft. We report on a case of a mycotic pseudoaneurysm originating in the abdominal aorta at the level of superior mesenteric artery, which was treated with a customized stent-graft.

키워드

참고문헌

  1. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991;5:491-499 https://doi.org/10.1007/BF02015271
  2. Verhoeven EL, Tielliu IF, Muhs BE, Bos WT, Zeebregts CJ, Prins TR, et al. Fenestrated and branched stent-grafting: a 5-years experience. Acta Chir Belg 2006;106:317-322
  3. Park JH, Chung JW, Choo IW, Kim SJ, Lee JY, Han MC. Fenestrated stent-grafts for preserving visceral arterial branches in the treatment of abdominal aortic aneurysms: preliminary experience. J Vasc Interv Radiol 1996;7:819-823 https://doi.org/10.1016/S1051-0443(96)70854-0
  4. Takahashi S, Takaya S, Fukuda I, Suto T, Daitoku K, Kuga T, et al. Stent graft treatment for abdominal pseudoaneurysm near the celiac artery. J Thorac Cardiovasc Surg 2003; 126:600-602 https://doi.org/10.1016/S0022-5223(03)00127-2
  5. Wanhainen A, Ljungman C, Eriksson LG. "Homemade" oversized fenestrations for emergency endovascular repair of a mycotic saccular aortic aneurysm. J Vasc Interv Radiol 2010;21:405-406 https://doi.org/10.1016/j.jvir.2009.10.037
  6. Scurr JR, Brennan JA, Gilling-Smith GL, Harris PL, Vallabhaneni SR, McWilliams RG. Fenestrated endovascular repair for juxtarenal aortic aneurysm. Br J Surg 2008;95: 326-332 https://doi.org/10.1002/bjs.5979
  7. Ohrlander T, Sonesson B, Ivancev K, Resch T, Dias N, Malina M. The chimney graft: a technique for preserving or rescuing aortic branch vessels in stent-graft sealing zones. J Endovasc Ther 2008;15:427-432 https://doi.org/10.1583/07-2315.1
  8. Park KM, Kim JY, Jung JE, Jeon YS, Cho SG, Choe YM, et al. Clinical Experience of Endoleak after Endovascular Aortic Aneurysm Repair. J Korean Surg Soc 2010;78:231-237 https://doi.org/10.4174/jkss.2010.78.4.231
  9. Zhou T, Guo D, Chen B, Jiang J, Fu W, Wang Y. Endovascular stent-graft repair of mycotic aneurysms of the aorta: a case series with a 22-month follow-up. World J Surg 2009;33:1772-1778 https://doi.org/10.1007/s00268-009-0075-6