Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
J Vasc Surg. 2014 Jan;59(1):264-7. doi: 10.1016/j.jvs.2013.07.101.
We report the first successful hybrid endovascular technique for treating a residual dissecting thoracoabdominal aortic aneurysm with a compressed true lumen in a 48-year-old man in whom multiple stent grafts were deployed through the false lumen. The first stage of the procedure involved debranching of the visceral vessels from the right external iliac artery. In the second stage, a Gore excluder iliac extender (W. L. Gore and Associates, Flagstaff, Ariz) was deployed through the false lumen of the left common iliac artery; then, a Powerlink bifurcated stent graft (Endologix, Irvine, Calif) was positioned at the false lumen of the abdominal aorta. Overlapping with this stent graft, three Gore TAG stent grafts were deployed upward toward the Dacron (DuPont, Wilmington, Del) graft implanted during a previous operation on the descending aorta. Subsequently, the patient had an uneventful postoperative course, with no complications at the 3-year follow-up. The successful results of our new hybrid endovascular technique suggest the feasibility and efficacy of stent graft implantation through the false lumen.
我们报告首例成功的杂交血管内技术治疗 1 例 48 岁男性患者残留夹层胸腹主动脉瘤，该患者的真腔受压，且其内曾植入多枚支架移植物。该患者的第一阶段手术包括内脏血管从右髂外动脉分出来；第二阶段，在左髂总动脉的假腔内置入戈尔 excluder 髂 extender（戈尔公司，亚利桑那州弗拉格斯塔夫）；然后，在腹主动脉的假腔内置入 Powerlink 分叉支架移植物（Endologix，加利福尼亚州欧文）。重叠于此支架移植物之上，向上置入 3 枚戈尔 TAG 支架移植物，直至到达先前降主动脉手术植入的涤纶（杜邦公司，特拉华州威尔明顿）移植物。随后，患者术后恢复顺利，3 年随访时无并发症。我们的新型杂交血管内技术的成功结果表明通过假腔植入支架移植物的可行性和疗效。
