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血管腔内主动脉瘤修复术后B型主动脉夹层致支架移植物移位的成功杂交治疗:1例报告

Successful Hybrid Treatment of Stent-Graft Migration Caused by Type B Aortic Dissection after Endovascular Aortic Aneurysm Repair: A Case Report.

作者信息

Shintani Tsunehiro, Atsuta Kouji, Saito Takaaki

机构信息

Department of Vascular Surgery, Shizuoka Red Cross Hospital, Shizuoka, Japan.

出版信息

Ann Vasc Dis. 2017 Sep 25;10(3):270-3. doi: 10.3400/avd.cr.17-00044.

Abstract

Herein, we report a rare case of type B aortic dissection that occurred after endovascular aortic aneurysm repair (EVAR). A 66-year-old man underwent successful EVAR for an abdominal aortic aneurysm (AAA). Computed tomography (CT) 2 years after EVAR showed a type B aortic dissection with stent-graft migration and AAA expansion. Juxtarenal aortic expansion precluded simple stent-graft placement. He underwent hepato-spleno-renal bypass followed by stent-graft placement just below the superior mesenteric artery. Postoperative CT showed no endoleaks. This case reconfirms the importance of regular follow-up after EVAR and illustrates the usefulness of a hybrid approach.

摘要

在此,我们报告一例血管腔内主动脉瘤修复术(EVAR)后发生的罕见B型主动脉夹层病例。一名66岁男性因腹主动脉瘤(AAA)成功接受了EVAR。EVAR术后2年的计算机断层扫描(CT)显示为B型主动脉夹层伴覆膜支架移位和AAA扩大。肾旁主动脉扩张使得无法简单地放置覆膜支架。他接受了肝脾肾分流术,随后在肠系膜上动脉下方放置了覆膜支架。术后CT显示无内漏。该病例再次证实了EVAR术后定期随访的重要性,并说明了杂交手术方法的实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/5684157/92efe6bf0094/avd-10-3-cr.17-00044-figure01.jpg

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