Kitabayashi Katsukiyo, Sakaki Masayuki, Araki Kanta, Shibamoto Ai, Mizoguchi Hiroki, Ohtake Shigeaki
Department of Cardiovascular Surgery, Osaka Police Hospital, Osaka, Japan.
Ann Vasc Surg. 2013 Aug;27(6):802.e5-7. doi: 10.1016/j.avsg.2012.08.015. Epub 2013 Mar 25.
A 39-year-old man with a thoracic aortic aneurysm and pseudocoarctation underwent graft replacement of the distal arch. The left subclavian artery, which rose just after the aneurysm, was also reconstructed at surgery. The aneurysmal wall was extremely thin, and the adventitia and a small amount of medial tissue were found on histologic examination. Thus, surgical treatment was recommended due to risk of rupture. Furthermore, because aneurysms involved the cervical branch, separate reconstruction was also performed. Endovascular intervention is not appropriate for this group of patients because of the complex kinking of the aorta and the extremely thin aneurysmal wall.
一名患有胸主动脉瘤和假性缩窄的39岁男性接受了远段主动脉弓移植置换术。在动脉瘤后方起始的左锁骨下动脉在手术中也进行了重建。动脉瘤壁极其薄，组织学检查发现有外膜和少量中层组织。因此，鉴于破裂风险，建议进行手术治疗。此外，由于动脉瘤累及颈部分支，也进行了单独重建。由于主动脉存在复杂的扭曲以及动脉瘤壁极薄，血管内介入治疗不适用于这类患者。
