Fujita Wakako, Taniguchi Satoshi, Daitoku Kazuyuki, Fukuda Ikuo
Department of Thoracic & Cardiovascular Surgery, Hirosaki University School of Medicine, Hirosaki City, 036-8562 Aomori, Japan.
Tex Heart Inst J. 2010;37(6):691-4.
The most common treatment of acute type A aortic dissection is immediate surgical repair. However, early surgery for acute dissections with peripheral vascular compromise carries a high mortality rate. Herein, we report a case in which we placed percutaneous endovascular stents in a type A dissection patient before proceeding with proximal aortic repair. Bare-metal stents were placed into the obliterated true channel of the abdominal aorta and the left external iliac artery. Endovascular stenting immediately relieved the lower-left-extremity ischemic symptoms, and the patient underwent hemi-arch replacement 7 days after the procedure. Stent placement for patients who have acute aortic dissection with malperfusion can be used as "bridge therapy."
急性A型主动脉夹层最常见的治疗方法是立即进行手术修复。然而，对于伴有外周血管受损的急性夹层进行早期手术，死亡率很高。在此，我们报告一例病例，在对一名A型夹层患者进行近端主动脉修复之前，我们为其置入了经皮血管内支架。裸金属支架被置入腹主动脉和左髂外动脉闭塞的真腔内。血管内支架置入立即缓解了左下肢缺血症状，患者在术后7天接受了半弓置换术。对于患有急性主动脉夹层伴灌注不良的患者，支架置入可作为“桥接治疗”。
