1 Department of Vascular and Endovascular Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
J Endovasc Ther. 2017 Dec;24(6):814-818. doi: 10.1177/1526602817725265. Epub 2017 Aug 17.
To describe an innovative endovascular technique that successfully reconstructs a renal artery completely perfused by the false lumen after thoracic endovascular aortic repair (TEVAR).
A 65-year-old patient diagnosed with acute Stanford type B aortic dissection underwent successful TEVAR 4 years ago. Regular follow-up found that the thoracic aorta was well repaired, but the false lumen in the abdominal aorta had enlarged year by year. The left renal artery was supplied entirely by the false lumen, which caused kidney hypoperfusion. The abdominal aorta was successfully remodeled using endovascular aneurysm repair with reconstruction of the left renal artery using Viabahn stent-grafts inserted through the patent false lumen. At 6 months, computed tomography showed false lumen thrombosis and patent Viabahn stent-grafts in the false lumen.
The false lumen reverse branch technique was feasible in our case, which provides a new idea for dealing with distal dissection involving the renovisceral arteries after TEVAR.
描述一种创新性的血管内技术，成功地重建了胸主动脉腔内修复术（TEVAR）后完全由假腔供血的肾动脉。
一位 65 岁的患者，诊断为急性 Stanford 型 B 型主动脉夹层，4 年前成功进行了 TEVAR。定期随访发现胸主动脉修复良好，但腹主动脉的假腔逐年增大。左肾动脉完全由假腔供应，导致肾脏灌注不足。通过在通畅的假腔中插入 Viabahn 支架移植物，成功地进行了血管内动脉瘤修复，重建了左肾动脉，对腹主动脉进行了重塑。6 个月后，计算机断层扫描显示假腔血栓形成，假腔中有通畅的 Viabahn 支架移植物。
在我们的病例中，假腔反向分支技术是可行的，为 TEVAR 后涉及肾动脉的远端夹层提供了一个新的处理思路。
