Yoshida H, Izumi Y, Magishi K, Ishikawa N, Kubota H, Uchida S
Department of Thoracic and Cardiovascular Surgery, Nayoro City Hospital, Japan.
Kyobu Geka. 2000 Aug;53(9):734-7.
Patients with aneurysmal disease involving both the thoracic and abdominal aorta have historically required simultaneous or sequential conventional operations. Staged operations were generally preferred, but we experienced that a patient had rupture of the second aneurysm after he finished initial treatment for the first aneurysm. We have implemented simultaneous operation using thoracic stent-graft placement. A 78-year-old male who had multiple aortic aneurysm involving both the thoracic and abdominal aorta underwent conventional abdominal aortic replacement with endovascular stent-graft placement into the distal arch of the thoracic aorta under fluoroscopic guidance. The stent-graft was composed of two units of self-expanding stainless-steel Z stent covered with an thin wall woven Dacron graft. Postoperative aortography showed no stent migration and no endoleak. Simultaneous abdominal aortic replacement and deployment of a thoracic stent-graft may be a valuable treatment option for these patients. However, careful long term follow up is necessary to prove the value and the effects of the endovascular treatment.
累及胸主动脉和腹主动脉的动脉瘤疾病患者，历来需要同时或先后进行传统手术。分期手术通常更受青睐，但我们曾遇到一名患者，在完成首个动脉瘤的初始治疗后，第二个动脉瘤发生了破裂。我们采用了经胸主动脉覆膜支架置入术进行同期手术。一名78岁男性，患有累及胸主动脉和腹主动脉的多发主动脉瘤，在透视引导下接受了传统腹主动脉置换术，并在胸主动脉远侧弓部置入了血管内覆膜支架。该覆膜支架由两个自膨式不锈钢Z形支架单元组成，表面覆盖有薄壁编织涤纶移植物。术后主动脉造影显示无支架移位及内漏。同期腹主动脉置换术和胸主动脉覆膜支架置入术可能是这些患者的一种有价值的治疗选择。然而，需要进行仔细的长期随访，以证实血管内治疗的价值和效果。
