Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Division of Vascular Surgery, Department of Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
J Vasc Surg. 2019 Jan;69(1):249-252. doi: 10.1016/j.jvs.2018.06.200. Epub 2018 Aug 31.
Chronic type B aortic dissection with aneurysmal degeneration requiring intervention presents significant therapeutic challenges. Thoracic endovascular aortic repair with a fenestrated endograft is a feasible option, but false lumen branches without an adjacent re-entry or perforation in the septum can pose a significant challenge. We present two cases of fenestrated endovascular aneurysm repair for chronic type B aortic dissection in which a renal artery from the false lumen was cannulated by creating a "neofenestration" through the dissection flap using a radiofrequency PowerWire (Baylis Medical Inc, Montreal, Quebec, Canada) technique (Toronto PowerWire fenestration technique).
慢性 B 型主动脉夹层伴动脉瘤样退行性变需要介入治疗，这带来了重大的治疗挑战。胸主动脉腔内修复术联合开窗移植物是一种可行的选择，但假腔分支如果没有毗邻的再入口或中隔穿孔，则会带来重大挑战。我们介绍了两例使用射频PowerWire（Baylis Medical Inc，加拿大魁北克省蒙特利尔）技术（多伦多 PowerWire 开窗技术）通过夹层瓣创建“新开窗”对慢性 B 型主动脉夹层的开窗血管腔内修复术治疗的病例，其中假腔的肾动脉被导管插入。
