He Yangyan, Wu Ziheng, Zhang Hongkun, Li Donglin, Li Ming, Jin Wei, Ai-kalei Adel
Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
Vasc Endovascular Surg. 2013 Apr;47(3):245-9. doi: 10.1177/1538574413479180. Epub 2013 Feb 27.
A 59-year-old man with hypertension was found to have a Stanford type B aortic dissection with a false lumen extending to the abdominal aorta. We placed a stent graft to the thoracic aorta covering the proximal entry and planned a second endovascular repair to cover the entries in the abdominal aorta. Five years later, computed tomography angiography revealed an extensive dissection to the right common iliac artery with multiple intimal tears. We placed stent grafts in the distal end of the primary stent graft and an abdominal stent graft to the aortic bifurcation to cover the entry tears. However, 3 months later it developed into a newly formed intimal tear in the right renal artery, leading to retrograde reperfusion into the false lumen. The patient was successfully treated with a third time endovascular repair and recovered smoothly during follow-up.
一名59岁的高血压男性被发现患有斯坦福B型主动脉夹层，假腔延伸至腹主动脉。我们在胸主动脉放置了覆膜支架以覆盖近端破口，并计划进行第二次血管腔内修复以覆盖腹主动脉的破口。五年后，计算机断层血管造影显示右髂总动脉广泛夹层并伴有多处内膜撕裂。我们在主覆膜支架远端放置了覆膜支架，并在主动脉分叉处放置了腹主动脉覆膜支架以覆盖破口撕裂处。然而，3个月后右肾动脉出现了新形成的内膜撕裂，导致逆行再灌注进入假腔。该患者通过第三次血管腔内修复成功治疗，随访期间恢复顺利。
