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B型慢性主动脉夹层合并行走运动诱发下肢灌注不良的主动脉开窗术

Aortic fenestration for type B chronic aortic dissection complicated with lower limb malperfusion induced by walking exercise.

作者信息

Arata Kenichi, Imagama Itsumi, Shigehisa Yoshiya, Mukaihara Kousuke, Toyokawa Kenji, Matsuba Tomoyuki, Imoto Yutaka

机构信息

Cardiovascular and Gastroenterological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan.

出版信息

Ann Vasc Dis. 2015;8(1):29-32. doi: 10.3400/avd.cr.14-00101. Epub 2015 Mar 2.

DOI:10.3400/avd.cr.14-00101
PMID:25848428
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4369563/
Abstract

We report a case of a 55-year-old male with type B-chronic aortic dissection. Patient presented with intermittent claudication due to limb malperfusion resulting from expansion of a patent false lumen during walking regardless of normal range ankle-brachial index (ABI) at rest. Preoperative stress vascular ultrasonography was an effective modality for proper diagnosis. We should be concerned of reversible ischemia due to the dissection flap in patients with type B aortic dissection. Fenestration of the aorta can be a choice of treatment in such patients. The patient has been doing well with no ischemia for 3.5 years after the operation.

摘要

我们报告一例55岁男性B型慢性主动脉夹层病例。患者因行走时未闭假腔扩张导致肢体灌注不良而出现间歇性跛行，尽管静息时踝肱指数（ABI）正常。术前应力血管超声检查是一种有效的正确诊断方法。我们应关注B型主动脉夹层患者因夹层瓣导致的可逆性缺血。对于此类患者，主动脉开窗术可作为一种治疗选择。该患者术后3.5年情况良好，未出现缺血症状。

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本文引用的文献

1
Lower limb malperfusion in type B aortic dissection: a systematic review.B型主动脉夹层中的下肢灌注不良：一项系统评价
Ann Cardiothorac Surg. 2014 Jul;3(4):351-67. doi: 10.3978/j.issn.2225-319X.2014.07.05.
2
Postural change causing leg malperfusion resulting from expansion of a patent false lumen in type B aortic dissection.B型主动脉夹层中，因未闭假腔扩张导致体位改变引起下肢灌注不良。
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Aortic fenestration for chronic aortic dissection type B complicated by transient ischemic attacks of spinal cord.针对慢性B型主动脉夹层并发脊髓短暂性缺血发作的主动脉开窗术。
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Surgical considerations of dissecting aneurysm of the aorta.主动脉夹层动脉瘤的外科治疗考量
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Aortic fenestration for acute or chronic aortic dissection: an uncommon but effective procedure.主动脉开窗术治疗急性或慢性主动脉夹层：一种罕见但有效的手术。
J Vasc Surg. 2000 Oct;32(4):711-21. doi: 10.1067/mva.2000.110054.
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Vascular complications associated with spontaneous aortic dissection.与自发性主动脉夹层相关的血管并发症。
J Vasc Surg. 1988 Feb;7(2):199-209.
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