Campbell Michael J, Raker Edmond J, Farrokhi Ellen
Department of General Surgery, Virginia Mason Medical Center, Seattle, WA 98101, USA.
Vasc Endovascular Surg. 2011 Aug;45(6):561-4. doi: 10.1177/1538574411409064. Epub 2011 Jun 5.
Spontaneous abdominal aortic dissection (AAD) with retrograde thoracic extension is an extremely rare occurrence with a high mortality. Abdominal aortic dissection can be associated with an abdominal aortic aneurysm (AAA) and the presence of an AAD with an AAA mandates surgical intervention because of a high rate of rupture. We present the case of a 53-year-old woman with a spontaneous AAD that extended retrograde into the thoracic aorta with a concomitant supraceliac intimal tear and an infrarenal AAA repaired electively with a hybrid approach using a supraceliac stent graft and an open infrarenal aortobiiliac graft. This hybrid approach provided an excellent outcome of this rare and complex vascular pathology.
自发性腹主动脉夹层（AAD）伴逆行性胸段扩展极为罕见，死亡率很高。腹主动脉夹层可与腹主动脉瘤（AAA）相关，而存在AAD合并AAA时，由于破裂率高，需要进行手术干预。我们报告一例53岁女性患者，患有自发性AAD，逆行扩展至胸主动脉，同时伴有腹腔干上方内膜撕裂和肾下腹主动脉瘤，采用腹腔干上方支架移植物和开放肾下主动脉双髂动脉移植物的杂交方法进行了选择性修复。这种杂交方法为这种罕见且复杂的血管病变提供了良好的治疗效果。
