摘要目的 总结分析主髂动脉病变腔内治疗术中髂动脉术中破裂及延迟破裂的处理.方法 回顾性分析北京大学人民医院自2008年11月至2014年8月收治的225例主髂动脉病变腔内治疗术中发生的8例髂动脉破裂的临床资料,包括术中即刻发现的破裂4例,延迟破裂4例,所有患者主髂动脉病变均为TASC D级.7例采用覆膜支架封堵破口,1例放弃治疗. 结果 所有接受治疗患者均成功置入覆膜支架,术后造影明确髂动脉破口完全封堵,技术成功率100％.术后循环均恢复稳定,腹痛症状消失,1例患者术前心功能衰竭,术后死于多器官功能衰竭,1例死于误吸.随访时间分别为9、12、12、13、52个月,随访期间无再发髂动脉破裂、支架内再狭窄等并发症发生.结论 髂动脉破裂出血,特别是髂动脉延迟破裂是主髂动脉病变腔内治疗过程中一种常见的危险并发症,使用覆膜支架封堵出血点,是髂动脉破裂出血的一种安全、迅速、有效的治疗方法.

abstractsObjective To evaluate iliac artery rupture during endovascular treatment of aorto-iliac disease and treatment with covered stent.Methods From November 2008 to August 2014,iliac artery rupture happened in 8 patients of 225 patients of aorto-iliac artery disease admitted to our hospital.Clinical data of the 8 patients were analyzed retrospectively.Four were of intraoperative rupture and four were of delayed rupture.The aorto-iliac diease of all the 8 patients were TSAC D.Direct placement of a covered stent was performed in all the cases,except for one patient who refused further treatment.Results All of the procedures finally achieved technical success and all patients become hemodynamically stable.One patient was complicated with heart failure who died of multiple organ dysfunction syndrome.Another one died of aspiration.5 patients were followed up from 9-52 moths,average 9-52 moths without recurrence.Conclusions Iliac artery rupture is a serious and life-threatening complication in the endovascular treatment of aorto-iliac disease.Covered stent provided a safe and effective treatment for iliac perforations.