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胸主动脉腔内修复术(TEVAR)在治疗合并斯坦福B型主动脉夹层的侏儒症中的应用:一例报告

Application of thoracic endovascular aortic repair (TEVAR) in treating dwarfism with Stanford B aortic dissection: A case report.

作者信息

Qiu Jian, Cai Wenwu, Shu Chang, Li Ming, Xiong Qinggen, Li Quanming, Li Xin

机构信息

Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.

出版信息

Medicine (Baltimore). 2018 Apr;97(17):e0542. doi: 10.1097/MD.0000000000010542.

DOI:10.1097/MD.0000000000010542
PMID:29703033
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5944474/
Abstract

RATIONALE

To apply thoracic endovascular aortic repair (TEVAR) to treat dwarfism complicated with Stanford B aortic dissection.

PATIENT CONCERNS

In this report, we presented a 63-year-old male patient of dwarfism complicated with Stanford B aortic dissection successfully treated with TEVAR.

DIAGNOSES

He was diagnosed with dwarfism complicated with Stanford B aortic dissection.

INTERVENTIONS

After conservative treatment, the male patient underwent TEVAR at 1 week after hospitalization. After operation, he presented with numbness and weakness of his bilateral lower extremities, and these symptoms were significantly mitigated after effective treatment. At 1- and 3-week after TEVAR, the aorta status was maintained stable and restored.

OUTCOMES

The patient obtained favorable clinical prognosis and was smoothly discharged. During subsequent follow-up, he remained physically stable.

LESSONS

TEVAR is probably an option for treating dwarfism complicated with Stanford B aortic dissection, which remains to be validated by subsequent studies with larger sample size.

摘要

原理

应用胸主动脉腔内修复术(TEVAR)治疗侏儒症合并Stanford B型主动脉夹层。

患者情况

在本报告中,我们介绍了一名63岁患有侏儒症合并Stanford B型主动脉夹层的男性患者,成功接受了TEVAR治疗。

诊断

他被诊断为侏儒症合并Stanford B型主动脉夹层。

干预措施

经过保守治疗后,该男性患者在住院1周后接受了TEVAR治疗。术后,他出现双下肢麻木和无力,经有效治疗后这些症状明显减轻。TEVAR术后1周和3周时,主动脉状态保持稳定并恢复。

结果

患者获得了良好的临床预后并顺利出院。在随后的随访中,他身体状况保持稳定。

经验教训

TEVAR可能是治疗侏儒症合并Stanford B型主动脉夹层的一种选择,这仍有待后续更大样本量的研究来验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8597/5944474/c235f29dfd78/medi-97-e0542-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8597/5944474/64d531c5e65d/medi-97-e0542-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8597/5944474/9b438883dec4/medi-97-e0542-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8597/5944474/c235f29dfd78/medi-97-e0542-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8597/5944474/64d531c5e65d/medi-97-e0542-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8597/5944474/9b438883dec4/medi-97-e0542-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8597/5944474/c235f29dfd78/medi-97-e0542-g003.jpg

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本文引用的文献

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Acute Type A Dissection Repair in an Achondroplastic Dwarf: Anesthetic, Perfusion, and Surgical Concerns.一名软骨发育不全侏儒的急性A型主动脉夹层修复术:麻醉、灌注及手术相关问题
Aorta (Stamford). 2014 Aug 1;2(4):143-6. doi: 10.12945/j.aorta.2014.14-020. eCollection 2014 Aug.
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Advanced endovascular techniques for thoracic and abdominal aortic dissections.用于胸主动脉和腹主动脉夹层的先进血管内技术。
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Endovascular treatment of thoracoabdominal aortic aneurysms.胸主动脉腹主动脉瘤的血管内治疗。
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Complete reversal of paraplegia after thoracic endovascular aortic repair in a patient with complicated acute aortic dissection using immediate cerebrospinal fluid drainage.在一名患有复杂急性主动脉夹层的患者中,采用即时脑脊液引流,经胸主动脉腔内修复术后截瘫完全逆转。
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Incidence and determinants of spinal cord ischaemia in stent-graft repair of the thoracic aorta.胸主动脉支架移植物修复术中脊髓缺血的发生率及决定因素。
Eur J Vasc Endovasc Surg. 2008 Apr;35(4):455-61. doi: 10.1016/j.ejvs.2007.11.005. Epub 2008 Jan 3.
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Neurologic complications associated with endovascular repair of thoracic aortic pathology: Incidence and risk factors. a study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry.胸主动脉病变血管内修复相关的神经系统并发症:发生率及危险因素。一项来自欧洲主动脉瘤修复支架/移植物技术协作组(EUROSTAR)注册研究。
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Perioperative management to improve neurologic outcome in thoracic or thoracoabdominal aortic stent-grafting.改善胸主动脉或胸腹主动脉支架植入术神经学预后的围手术期管理。
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