关键词: 腔内修复, 腹主动脉瘤, 主动脉破裂, 开放手术

Abstract: Diagnosis and treatment of ruptured abdominal aortic aneurysm after endovascular treatment        WANG Tun，LI Quan-ming，HE Hao，et al. Department of Vascular Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
Corresponding author：SHU Chang, E-mail：changshu01@
yahoo.com
WANG Tun and LI Quan-ming are the first authors who contributed equally to the article.
Abstract    Rupture of abdominal aortic aneurysm（AAA）after endovascular aortic repair（EVAR）is a life-threatening aortic disease. With the development and spread of EVAR and the increasing of the expected life of the AAA patient after EVAR，the incidence of AAA rupture after EVAR increases obviously，which is much higher than expectation of the researches previously. In order to detect the risk of AAA rupture，the effective long-term follow-up and the pathogenesis of AAA，especially atherosclerosis and systematic inflammatory disease，which are significant to the long-term complications of AAA after EVAR，should be given greater prominence. The surgical treatment strategy of the disease should be made individually according to the specific pathogenesis and anatomic situation. However，the pooled estimate for perioperative mortality is high. Endovascular method is the preferred treatment. The technique with fenestrations on a cuff stent graft can be used to seal type Ia endoleak with a complicated proximal landing zone.The“skirt technique”is an effective method in the treatment of type Ⅰb endoleak caused by a common/internal iliac aneurysm. Open surgery is used for the patient with complicated anatomic situations. The aortic contraction surgery associated with the technique of aortic interruption with a compliant aortic balloon is an effective and reliable method to keep hemodynamics stable and cure aortic rupture.

Key words: endovascular aortic repair, abdominal aortic aneurysm, aortic rupture, open surgery