van Prehn Joffrey, van Herwaarden Joost A, Muhs Bart E, Arnofsky Adam, Moll Frans L, Verhagen Hence J M
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
J Vasc Surg. 2008 Jun;47(6):1333-6. doi: 10.1016/j.jvs.2007.12.036.
A patient with traumatic thoracic injury and hypovolemic shock is presented to stress important differences in preoperative and postoperative aortic diameters. The patient had a blood pressure of 80/40 mm Hg. A diagnostic computed tomography angiography revealed a rupture of the thoracic aorta, and a thoracic endograft was sized based on these data. However, the postoperative computed tomography angiography (Riva-Rocci, 164/70 mm Hg) showed an increase in aortic diameters of about 30% at multiple levels. In this patient, with rupture of the thoracic aorta and hypovolemia, the aortic diameter was significantly decreased. This indicates that adequate preoperative sizing for endovascular repair of vascular pathology in patients in shock is complicated.
一名患有创伤性胸部损伤和低血容量性休克的患者被用来强调术前和术后主动脉直径的重要差异。该患者血压为80/40 mmHg。诊断性计算机断层扫描血管造影显示胸主动脉破裂，并根据这些数据确定了胸主动脉内移植物的尺寸。然而，术后计算机断层扫描血管造影（里瓦-罗西，164/70 mmHg）显示多个层面的主动脉直径增加了约30%。在这名患有胸主动脉破裂和低血容量的患者中，主动脉直径明显减小。这表明，对于休克患者血管病变的血管内修复，术前进行充分的尺寸测量很复杂。
