Hashimoto Kazunori, Itoh Satoshi, Tajima Yasushi, Kimura Naoyuki, Yuri Kohichi, Matumoto Harunobu, Adachi Kohichi, Yamaguchi Atushi, Adachi Hideo
Department of Cardiovascular Surgery, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Kyobu Geka. 2015 May;68(5):371-4.
A 74-year-old female patient experienced sudden and severe pain in her lower back and both legs. Upon examination, her femoral pulses were weak, and her legs were pale. Computed tomography revealed a 66-mm thoracic aneurysm in the distal arch and type B aortic dissection. Stenosis was present from the terminal aorta to the iliac arteries. The left common iliac artery was occluded at its bifurcation, and both lower limbs were ischemic. We performed bilateral axillary-femoral artery bypass, which improved blood flow to both limbs. The next day, it was apparent that compartment syndrome had developed in the patient's left leg. Rehabilitation therapy was effective for the compartment syndrome, the patient's symptoms resolved, and she was discharged. We later performed two-stage total arch replacement, and the subsequent clinical course has been without incident.
一名74岁女性患者突发下背部和双腿剧痛。检查发现，她的股动脉搏动微弱，双腿苍白。计算机断层扫描显示，主动脉弓远端有一个66毫米的胸主动脉瘤以及B型主动脉夹层。从主动脉末端到髂动脉存在狭窄。左髂总动脉在其分叉处闭塞，双下肢缺血。我们进行了双侧腋-股动脉旁路移植术，改善了双下肢的血流。第二天，很明显患者左腿出现了骨筋膜室综合征。康复治疗对骨筋膜室综合征有效，患者症状缓解并出院。我们后来进行了两阶段全主动脉弓置换术，随后的临床过程无异常。
