Manke C, Strotzer M, Seitz J, Lenhart M, Aebert H, Kasprzak P, Kaiser B, Feuerbach S
Institut für Röntgendiagnostik.
Rofo. 1999 Feb;170(2):198-204.
To describe principles and results of percutaneous treatment of ischemic complications of aortic dissection.
In five cases (four patients) aortic dissection was clinically complicated by renal (n = 4), iliofemoral (n = 2) or mesenterial ischemia (n = 1). After evaluation by means of computed tomography, angiography, and manometry, treatment consisted of balloon fenestration of the intimal flap, stent placement or both.
Eleven of 25 vascular beds were classified as ischemic. Treatment consisted of 11 balloon fenestration procedures in 3 patients, in one case supported by stent placement across the dissection membrane. Stents were placed in five renal arteries, one stent was placed in the true lumen of the aorta. One iliac artery was treated with balloon dilatation. One renal artery dissection became symptomatic after balloon fenestration and was treated successfully by stent placement. In all cases ischemia was resolved by endovascular treatment. All patients had persistent relief of symptoms. Mean follow-up time is 5.8 months.
Ischemic complications of aortic dissection can be effectively and safely treated with stent placement and balloon fenestration.
描述经皮治疗主动脉夹层缺血性并发症的原则和结果。
5例（4名患者）主动脉夹层临床上合并肾缺血（n = 4）、髂股动脉缺血（n = 2）或肠系膜缺血（n = 1）。经计算机断层扫描、血管造影和测压评估后，治疗包括内膜瓣球囊开窗、支架置入或两者结合。
25个血管床中有11个被归类为缺血性。治疗包括对3例患者进行11次球囊开窗手术，其中1例在夹层膜上放置支架辅助。在5条肾动脉中放置了支架，1个支架放置在主动脉真腔内。1条髂动脉接受了球囊扩张治疗。1例肾动脉夹层在球囊开窗后出现症状，通过支架置入成功治疗。在所有病例中，缺血均通过血管内治疗得到解决。所有患者症状持续缓解。平均随访时间为5.8个月。
主动脉夹层缺血性并发症可通过支架置入和球囊开窗进行有效且安全的治疗。
