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采用真腔再循环的简化杂交修复术用于复杂慢性主动脉夹层的逆行肾内脏灌注

Simplified hybrid repair with true lumen recycling for retrograde renovisceral perfusion in a complex chronic aortic dissection.

作者信息

Castro-Ferreira Ricardo, Dias Paulo Gonçalves, Sampaio Sérgio Moreira, Teixeira José Fernando, Lachat Mario

机构信息

Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar de São João, Porto, Portugal.

Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

出版信息

J Vasc Surg Cases Innov Tech. 2018 Aug 29;4(3):226-230. doi: 10.1016/j.jvscit.2018.03.006. eCollection 2018 Sep.

DOI:10.1016/j.jvscit.2018.03.006
PMID:30175296
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6116411/
Abstract

A 59-year-old man was referred with complicated chronic type B aortic dissection. Despite the false lumen's being dominant in terms of caliber and limb perfusion, visceral arteries originated in a 9-mm true lumen. A staged approach was performed: open aortobi-iliac bypass with preservation of both lumens to the infrarenal aorta, with reinforcement of the aorta and anastomosis with Dacron (wrap technique); exclusion of the dissection by endografting all of the false lumen with three successive thoracic endoprostheses; and maintenance of true lumen perfusion using two periscopes with self-expanding nitinol stents. The patient remains asymptomatic after 1 year of follow-up.

摘要

一名59岁男性因复杂性慢性B型主动脉夹层被转诊。尽管假腔在管径和分支灌注方面占优势，但内脏动脉起源于一个9毫米的真腔。采用了分期治疗方法：行开放性主动脉双髂动脉旁路移植术，保留两个腔至肾下腹主动脉，同时加强主动脉并与涤纶进行吻合（包裹技术）；通过连续植入三个胸段血管内支架人工血管将所有假腔隔绝，从而排除夹层；使用两个带自膨式镍钛诺支架的潜望镜维持真腔灌注。随访1年后，患者仍无症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/ab7c2b0763d7/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/be6a49426887/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/5759cc9a95e9/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/0671757379ec/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/721851c1a57d/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/ab7c2b0763d7/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/be6a49426887/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/5759cc9a95e9/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/0671757379ec/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/721851c1a57d/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/6116411/ab7c2b0763d7/gr5.jpg

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本文引用的文献

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Editor's Choice - Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).编辑推荐——降主动脉疾病的管理：欧洲血管外科学会（ESVS）临床实践指南
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Contemporary Management Strategies for Chronic Type B Aortic Dissections: A Systematic Review.慢性B型主动脉夹层的当代管理策略：一项系统评价
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