ĐIỀU TRỊ PHỒNG ĐỘNG MẠCH CHỦ BỤNG – CHẬU BẰNG KỸ THUẬT CAN THIỆP NỘI MẠCH BẢO TỒN ĐỘNG MẠCH CHẬU TRONG

Abstract

Background: Recently, the development of specific endovascular interventions, such as endovascular aneurysm repair (EVAR), has brought many advantages such as significantly reducing blood loss, surgical time, rehospitalization rates, as well as mortality rates for patients with abdominal aortic aneurysms. However, abdominal aortic aneurysms accompanied by iliac artery aneurysms, which occur in over 40% of cases, can make treatment difficult without affecting blood supply to the pelvic area. Therefore, preserving the iliac artery in EVAR is an issue that needs attention and consideration. Methods: Case report. Results: A 61-year-old male patient was admitted to the hospital with abdominal pain and was diagnosed with abdominal aortic aneurysm with accompanying slow pulse, high blood pressure, and type 2 diabetes. Upon examination, the patient was found to have an infrarenal abdominal aortic aneurysm with a maximum diameter of 5.5 cm and bilateral iliac artery aneurysms with maximum diameters of 3 cm. The patient underwent right iliac artery occlusion and a stent graft was placed with a preserved left iliac artery branch. After the procedure, the stent graft was patent, the left iliac artery was open, there was no evidence of leakage, the functions were stable, and there were no symptoms of ischemia in the pelvic region. The patient was discharged after three days and re-evaluated after one week with stable indicators and improved symptoms. Conclusions: Preserving the internal iliac artery is the best option to reduce the risk of ischemia in the pelvic region. However, there should be a consideration between the risks and benefits as well as the skill of the surgeon and the conditions of the practice center