Department of Anesthesiology, Cardiovascular Center, Taichung Veterans General Hospital, Taipei, Taiwan.
Ann Thorac Surg. 2013 Feb;95(2):703-5. doi: 10.1016/j.athoracsur.2012.06.056.
A 58-year-old man with acute type B aortic dissection presented with right lower limb cyanosis, mesenteric ischemia, and acute renal failure. He was treated with extraanatomic right axillofemoral bypass surgery alone, recovered completely from renal, mesenteric, and lower extremity malperfusion shortly thereafter, and lived free of symptoms for the following year. Follow-up computed tomography angiograms documented adequate expansion of the true aortic lumen and good perfusion of visceral organs. Thus, managing such patients with coexisting visceral and extremity malperfusion may be accomplished with axillofemoral bypass exclusively, which can relieve ischemia of upstream abdominal organs and downstream lower extremities effectively and durably.
一位 58 岁男性，患急性 B 型主动脉夹层，出现右下肢发绀、肠系膜缺血和急性肾衰竭。他仅接受了非解剖学右侧腋股旁路手术治疗，此后不久肾功能、肠系膜和下肢灌注完全恢复，且在接下来的一年中没有症状。随访的 CT 血管造影显示真主动脉管腔充分扩张，内脏器官灌注良好。因此，对于合并内脏和肢体灌注不良的此类患者，仅采用腋股旁路手术即可完成治疗，可有效且持久地缓解上游腹部器官和下游下肢的缺血。
