Shintani Tsunehiro, Atsuta Kouji, Saito Takaaki
Department of Vascular Surgery, Shizuoka Red Cross Hospital, Shizuoka, Japan.
Ann Vasc Dis. 2017 Sep 25;10(3):270-3. doi: 10.3400/avd.cr.17-00044.
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.
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。