Nørgaard A, Andersen L I, Haahr P E, Justesen P
Department of Radiology, Odense University Hospital, Odense, Denmark.
Acta Radiol. 2008 Jun;49(5):510-2. doi: 10.1080/02841850801955227.
Surgical treatment of diseases of the thoracic aorta (aneurysms, dissections, and ruptures) may be associated with serious postoperative complications. Endovascular repair of thoracic aorta pathology is less invasive and offers a therapeutic alternative in high-surgical-risk patients, particularly in the presence of previous surgical repair of the thoracic aorta. The endovascular procedure, however, is almost only possible in the descending thoracic aorta, although advances have also been made in the aortic arch as well as in the ascending aorta with branched stent grafts. We report a case of a surgically treated aneurysm in the ascending thoracic aorta complicated with an anastomotic leak. If a short prosthesis (6 cm) had been available, the anastomotic leak would have been treated with endovascular repair. In lack of this prosthesis, we were forced to treat the patient with a method not generally accepted--embolization with endovascular coils--successfully resulting in occlusion of the leakage.
胸主动脉疾病(动脉瘤、夹层和破裂)的外科治疗可能会伴有严重的术后并发症。胸主动脉病变的血管内修复侵入性较小,为高手术风险患者提供了一种治疗选择,尤其是在既往有胸主动脉手术修复史的患者中。然而,血管内手术几乎仅适用于胸降主动脉,尽管在主动脉弓以及使用分支型支架移植物的升主动脉方面也取得了进展。我们报告一例升胸主动脉手术治疗的动脉瘤并发吻合口漏的病例。如果当时有一个短的人工血管(6厘米),吻合口漏就可以通过血管内修复来治疗。由于缺乏这种人工血管,我们被迫采用一种不被普遍接受的方法——用血管内线圈栓塞——成功地闭塞了漏口。