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主动脉内支架治疗一位老年患者的先天性主动脉缩窄及合并动脉瘤

Aortic Endoprosthesis for the Treatment of Native Aortic Coarctation and Concomitant Aneurysm in an Octogenarian Patient.

作者信息

Rabellino Martín, Kotowicz Vadim, Kenny Alberto, Kohan Andres Alejandro, García-Mónaco Ricardo

机构信息

Department of Interventional Radiology, Hospital Italiano, Buenos Aires, Argentina.

Department of Cardiovascular Surgery, Hospital Italiano, Buenos Aires, Argentina.

出版信息

Ann Vasc Surg. 2015 Nov;29(8):1661.e1-4. doi: 10.1016/j.avsg.2015.06.084. Epub 2015 Aug 28.

Abstract

We report a case of an 82-year-old female patient with native coarctation of the aorta and poststenotic aneurysm of the descending thoracic aorta. On consultation, she was receiving 4 antihypertensive drugs, and physical examination revealed nonpalpable lower-limb pulses with intermittent claudication at 50 min. Because of her age, high surgical risk and combination of lesions, endovascular treatment was suggested. Placement of a Valiant thoracic aorta endoprosthesis followed by coarctation angioplasty was performed. At 48 hr, the patient was discharged on 1 antihypertensive drug, palpable pulses on both limbs and a normal ankle-brachial index. At 1 month follow-up, the patient remained as discharged and multislice computed tomography angiography depicted complete coarctation expansion without residual stenosis, exclusion of the aortic aneurysm, and no signs of endoleaks.

摘要

我们报告一例82岁女性患者,患有先天性主动脉缩窄及胸降主动脉狭窄后动脉瘤。会诊时,她正在服用4种降压药,体格检查发现下肢脉搏触诊不清,行走50分钟后出现间歇性跛行。鉴于其年龄、高手术风险及病变组合情况,建议进行血管内治疗。置入了一枚Valiant胸主动脉腔内修复装置,随后进行了缩窄部位的血管成形术。术后48小时,患者仅服用1种降压药出院,双下肢脉搏可触及,踝肱指数正常。1个月随访时,患者情况同出院时,多层螺旋CT血管造影显示缩窄完全扩张,无残余狭窄,动脉瘤被隔绝,且无内漏迹象。

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