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11岁患者复杂性B型主动脉夹层的血管内支架置入术：病例报告

Endovascular stenting of a complicated type B aortic dissection in an 11-year-old patient: Case Report.

作者信息

Kazimierczak Arkadiusz, Rynio Paweł, Gutowski Piotr, Jedrzejczak Tomasz

机构信息

Department of Vascular Surgery Department of Cardiosurgery, Pomeranian Medical University in Szczecin, Powstancow, Wielkopolskich Szczecin, Poland.

出版信息

Medicine (Baltimore). 2018 Apr;97(14):e0279. doi: 10.1097/MD.0000000000010279.

DOI:10.1097/MD.0000000000010279
PMID:29620643
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5902282/
Abstract

RATIONALE

Endovascular aortic repair in children in the case of aortic dissection (AD) is currently unavailable. This is the first report of aortic dissection type B in an 11-years old child treated in endovascular way.

PATIENT CONCERNS

Complicated AD. Since bowel malperfusion and aortic rupture the surgery was necessary in emergency.

DIAGNOSES

Computed angio tomography.

INTERVENTION

The modified PETTICOAT technique (Provisional Extension To Induce Complete Attachment) was used.

OUTCOME

Full recovery.

LESSONS

For the first-time telescope modification were used, to allow aorta to grow with a child. Such a strategy seems to be possible with long overlap and lack of oversizing between implants.

摘要

原理

目前儿童主动脉夹层（AD）无法进行血管内主动脉修复。这是首例采用血管内治疗方法治疗的11岁儿童B型主动脉夹层报告。

患者情况

复杂主动脉夹层。因肠缺血和主动脉破裂，需紧急手术。

诊断

计算机血管断层扫描。

干预措施

采用改良的PETTICOAT技术（临时延伸以诱导完全附着）。

结果

完全康复。

经验教训

首次使用了望远镜式改良，以使主动脉能随儿童生长。通过长重叠和植入物之间不过度加大尺寸，这种策略似乎可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c2/5902282/6335e3e4f98e/medi-97-e0279-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c2/5902282/d6b7e7ce2e68/medi-97-e0279-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c2/5902282/6335e3e4f98e/medi-97-e0279-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c2/5902282/d6b7e7ce2e68/medi-97-e0279-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c2/5902282/6335e3e4f98e/medi-97-e0279-g002.jpg

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本文引用的文献

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Modified Petticoat Technique with Pre-placement of a Distal Bare Stent Improves Early Aortic Remodeling after Complicated Acute Stanford Type B Aortic Dissection.改良裙边技术联合预置远端裸支架在复杂急性 Stanford B 型主动脉夹层术后早期改善主动脉重塑。
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Management of acute type B aortic dissection.急性 B 型主动脉夹层的处理。
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伴有肠系膜灌注不良综合征的B型主动脉夹层的手术及血管腔内修复术：住院死亡率的系统评价
JTCVS Open. 2022 Aug 8;12:37-50. doi: 10.1016/j.xjon.2022.07.012. eCollection 2022 Dec.
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Endovascular stenting of blunt thoracic aortic injury in an 11-year-old.11 岁儿童钝性胸主动脉损伤的血管内支架置入术。
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