A Novel Combined Microsurgical and Endovascular Approach for Type II Endoleak Embolization Through Direct Puncture of a Lumbar Segmental Artery: A Technical Case Instruction.

Neurosurgery practice Pub Date : 2024-09-26 eCollection Date: 2024-12-01 DOI:10.1227/neuprac.0000000000000115

Vincent N Nguyen, Robert C Rennert, Sarah Sternbach, Jonathon Cavaleri, Aidin Abedi, Nadia A Atai, Sukgu Han, Jonathan J Russin

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Abstract

Background and importance: Despite the advances in endovascular aortic repair techniques, type II endoleaks with aneurysm sac expansion remain frequent and challenging problems.

Clinical presentation: An elderly gentleman underwent a combined microsurgical and endovascular procedure to address a type 2 endoleak and the growth of a recurrent abdominal aortic aneurysm caused by direct puncture of a lumbar segmental artery. The patient tolerated the procedure well and was discharged without complications. Follow-up imaging revealed no further endoleak and a smaller aneurysm size.

Conclusion: This unique case presents a novel multidisciplinary surgical strategy for treating complex, recurrent aortic aneurysms with type II endoleaks. The approach is tailored to the individual patient and has shown effectiveness. Long-term follow-up data will be crucial for assessing the efficacy and durability of this approach.

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一种新的显微外科和血管内联合入路，通过直接穿刺腰椎节段动脉进行II型内漏栓塞：一个技术病例指导。

背景和重要性：尽管血管内主动脉修复技术取得了进展，但II型血管内漏伴动脉瘤囊扩张仍然是常见和具有挑战性的问题。临床表现：一位老年男士接受了显微手术和血管内手术的联合治疗，以解决2型内漏和复发性腹主动脉瘤的生长，这是由腰椎节段动脉直接穿刺引起的。患者对手术耐受良好，出院时无并发症。随访影像显示没有进一步的内漏和较小的动脉瘤大小。结论：这个独特的病例提出了一种新的多学科手术策略来治疗复杂的复发性II型内漏主动脉瘤。该方法是针对个别患者量身定制的，并已显示出有效性。长期随访数据对于评估这种方法的有效性和持久性至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Neurosurgery practice

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