Rancic Zoran, Pfammatter Thomas, Lachat Mario, Frauenfelder Thomas, Veith Frank J, Mayer Dieter
Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
J Vasc Surg. 2009 Nov;50(5):1177-80. doi: 10.1016/j.jvs.2009.05.052. Epub 2009 Jul 22.
A floating thrombus within the aortic arch is a rare condition that is generally detected after cerebral, visceral, or peripheral embolization. Endovascular exclusion of such mobile thrombus has been described but exclusively involved the descending aorta, or debranching of the supra-aortic trunk was done by open surgical bypass procedure. We present a case with a floating thrombus that extended throughout the whole aortic arch and involved all of the supra-aortic trunks. The pathology was treated by debranching the supra-aortic trunks using a new nonsutured Viabahn-based (W. L. Gore & Associates, Flagstaff, Ariz) technique (Viabahn Open Revascularization TEChnique [VORTEC]) for revascularization of the left common carotid artery and performing an antegrade endograft implantation from the ascending aorta, distal to the origin of the feeding graft for debranching, to the descending aorta in one procedure.
主动脉弓内的漂浮血栓是一种罕见病症，通常在发生脑、内脏或外周栓塞后才被发现。虽然已有关于此类移动血栓的血管腔内封堵术的报道，但仅涉及降主动脉，或者通过开放手术旁路程序进行主动脉弓上干的去分支。我们报告了一例漂浮血栓延伸至整个主动脉弓并累及所有主动脉弓上干的病例。该病例采用一种新的基于非缝合Viabahn（W.L. Gore & Associates公司，亚利桑那州弗拉格斯塔夫）技术（Viabahn开放血管重建技术[VORTEC]）对主动脉弓上干进行去分支，以实现左颈总动脉的血管重建，并在一次手术中从升主动脉（在用于去分支的供血移植物起源远端）至降主动脉进行顺行性腔内移植物植入，从而对病变进行了治疗。
