Stent-Graft Relining in a Patient with Acute Aortic Aneurysm and a Completely Migrated Endograft

Abstract Stent-graft migration and type I endoleaks are associated with a higher rate of reintervention and increased mortality and morbidity. This article describes a patient presented with an infrarenal aortic stent-graft which had migrated into the aortic sac with loss of all aortic neck attachment. The acutely expanding abdominal aortic aneurysm was treated by placing a second modular endograft within and above the migrated stentgraft. The patient returned 36 months later, with features of an acute myocardial infarction, severe bilateral lower limb ischemia, and renal failure. He was too ill for intervention and demised within 48 hours.

摘要 覆膜支架（stent-graft）移位与I型内漏（type I endoleaks）均与更高的再干预率及升高的死亡率与并发症发生率相关。本文报道1例肾下主动脉覆膜支架（infrarenal aortic stent-graft）移位至主动脉囊（aortic sac）且完全丧失主动脉颈附着点（aortic neck attachment）的患者。该患者并发急性扩张性腹主动脉瘤（abdominal aortic aneurysm），术者于移位的覆膜支架内部及上方置入第二枚模块化覆膜支架（modular endograft）实施治疗。术后36个月患者复诊，表现为急性心肌梗死（acute myocardial infarction）、严重双侧下肢缺血（bilateral lower limb ischemia）及肾衰竭（renal failure）。因病情危重无法耐受干预操作，患者于48小时内死亡。