Da Rocha Marcio, Zarka Zaki Anas, Riambau Vicente A
Division of Vascular Surgery, Thorax Institute, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain.
Interact Cardiovasc Thorac Surg. 2009 Dec;9(6):947-50. doi: 10.1510/icvts.2009.214494. Epub 2009 Sep 18.
Endovascular correction of aorta thoracic pathology in renal transplant patients is a challenge. The aim of this study is to review early and intermediate-term results of endovascular repair of thoracic aorta pathology in patients with functioning previous renal transplant. The records of 81 patients submitted to a thoracic endograft between 2003 and 2008 were reviewed. Five patients with six previous renal transplants were submitted to six thoracic endografting. Two were women. The mean age was 55.4 years (range, 43-75 years). There were two patients with type B aortic dissection, one penetrating ulcer, one aneurysm of the aortic arch and one descending thoracic aorta aneurysm. Three patients underwent hybrid procedures: two total supra-aortic transpositions and one partial transposition of visceral trunks. Three patients presented postoperative complications. There were two cases of pneumonia, one acute limb ischemia and a stroke, with an early death. The mean follow-up was 16.2 months (range, 1-40 months). In this period all patients sustained renal function without any related complication. Despite the fact that it is a small series, in our clinical experience, endovascular thoracic aortic surgery can be performed as an alternative to open correction, in high-risk patients with a previous working renal transplant.
对肾移植患者进行胸主动脉病变的血管内矫正具有挑战性。本研究的目的是回顾既往肾移植功能正常的患者胸主动脉病变血管内修复的早期和中期结果。回顾了2003年至2008年间接受胸主动脉内移植物治疗的81例患者的记录。5例有过6次肾移植的患者接受了6次胸主动脉内移植物植入术。2例为女性。平均年龄为55.4岁（范围43 - 75岁）。有2例B型主动脉夹层患者、1例穿透性溃疡患者、1例主动脉弓动脉瘤患者和1例降主动脉胸段动脉瘤患者。3例患者接受了杂交手术：2例全主动脉弓上转位和1例内脏干部分转位。3例患者出现术后并发症。有2例肺炎、1例急性肢体缺血和1例中风，其中1例早期死亡。平均随访时间为16.2个月（范围1 - 40个月）。在此期间，所有患者肾功能均维持正常，无任何相关并发症。尽管本研究样本量较小，但根据我们的临床经验，对于既往有功能良好的肾移植的高危患者，血管内胸主动脉手术可作为开放矫正的替代方法。
