述评(Commentary)

腹主动脉瘤腔内修复术中髂内动脉的疏与堵

Published at: 2017年第26卷第12期

赵珺 1
1 上海交通大学附属第六人民医院 血管外科,上海 200233
通讯作者 珺 赵 Email: junnzhao@126.com
DOI: 10.3978/j.issn.1005-6947.2017.12.002
基金:

摘要

腹主动脉瘤腔内修复术(EVAR)中髂内动脉的疏与堵的问题,是长期伴随EVAR发展过程的焦点问题。笔者复习了数十篇国外文献,总结和分析了从百年前至今对髂内动脉的系统的解剖学研究、非血管外科手术过程中髂内动脉结扎或栓塞、腹主动脉与髂动脉开放手术中对髂内动脉实施结扎或栓塞、EVAR术中各种栓塞髂内动脉方式的临床后果、导致盆腔缺血各种并发症的危险因素,最终认为,EVAR术中,维持髂内动脉通畅是必要的,并对没有维持通畅的条件而必须栓塞髂内动脉,操作时如何防止或减少盆腔脏器缺血、具体实施技巧、术中术后注意事项等进行了归纳。


Preservation or occlusion of the hypogastric artery in endovascular abdominal aortic aneurysm repair

Abstract

Preservation or occlusion of the hypogastric artery in endovascular abdominal aortic aneurysm repair (EVAR) has long been a focus issue arising in the course of development of EVAR. Based on review of several dozen papers, the author extracts and analyzes the anatomical studies of the hypogastric artery system form a century ago to the present time, and the clinical consequences after ligation or embolization of the hyogastric artery in non-vascular operations or open surgery of the abdominal aorta and iliac artery, and after using different embolization methods of hypogastric artery during EVAR, as well as various risk factors for complications from pelvic ischemia. The final conclusion is that maintaining hypogastric artery patency in EVAR is essential. Moreover, for cases with no allowance for a patent hypogastric artery due to inevitable embolization, the measures to prevent or reduce pelvic organ ischemia, detailed operative skills and intraoperative attention points are also addressed.


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引用

引用本文: 珺 赵. 腹主动脉瘤腔内修复术中髂内动脉的疏与堵[J]. 中国普通外科杂志, 2017, 26(12): 1516-1524.
Cite this article as: ZHAO Jun . Preservation or occlusion of the hypogastric artery in endovascular abdominal aortic aneurysm repair[J]. Chin J Gen Surg, 2017, 26(12): 1516-1524.