Tasselli Sebastiano, Perini Paolo, Paini Elisa, Milan Luca, Bonvini Stefano
1 Department of Vascular Surgery, Santa Chiara Hospital, Trento, Italy.
2 Department of Vascular Surgery, University Hospital, Parma, Italy.
Vasc Endovascular Surg. 2017 Oct;51(7):493-497. doi: 10.1177/1538574417718446. Epub 2017 Jul 26.
We report the case of a thoracic endograft used to achieve exclusion of a ruptured proximal paranastomotic abdominal aortic aneurysm (PAAA) as a consequence of aortic ballooning.
A type I proximal endoleak was evidenced following endovascular repair of a PAAA with an aortic cuff. The leak was treated with ballooning, which caused distal aortic rupture. A thoracic endograft was deployed inside the cuff, achieving complete exclusion. At 1 year, there are no signs of migration or endoleak with complete PAAA thrombosis, according to computed tomographic angiography.
In hostile proximal abdominal aortic neck, challenging anatomies, or urgent cases, the structural adaptability of thoracic endografts could provide safe and successful abdominal aortic endovascular exclusion.
我们报告了一例因主动脉扩张导致近端吻合口旁腹主动脉瘤（PAAA）破裂，使用胸段血管内移植物实现其隔绝的病例。
在使用主动脉袖带对PAAA进行血管内修复后，发现I型近端内漏。通过球囊扩张治疗该漏口，却导致了远端主动脉破裂。在袖带内植入了胸段血管内移植物，实现了完全隔绝。根据计算机断层血管造影，1年后未见移植物移位或内漏迹象，PAAA完全血栓形成。
在近端腹主动脉颈部情况不佳、解剖结构复杂或紧急病例中，胸段血管内移植物的结构适应性可为腹主动脉血管内隔绝提供安全且成功的治疗。
