Department of Vascular Surgery, Toulouse, France.
Department of Thoracic and Cardiovascular Surgery, Montpellier, France.
Semin Thorac Cardiovasc Surg. 2019 Summer;31(2):227-229. doi: 10.1053/j.semtcvs.2019.01.014. Epub 2019 Jan 15.
Ten months after thoracic endovascular treatment of blunt thoracic aortic injury, a 15-year-old woman was admitted for chest pain, headache, and lower limbs weakness. Emergent computed tomography showed almost occlusive stenosis at the distal junction between the thoracic stent graft and the native thoracic due to clot formation inside the graft. She subsequently presented a pulmonary edema with concurrent anuria. Emergent angioplasty and stenting using nitinol bare stent was successfully performed. Blood pressure gradient between radial and femoral arteries decreased from 100 mm Hg to 25 mm Hg. Peripheral hypoperfusion signs progressively resolved and kidney function normalized. The patient was discharged 12 days later. Subcutaneous curative anticoagulation during 1 month associated with single antiplatelet therapy was administered. After a 2-month follow-up, the patient was asymptomatic and control CT scan showed a patent stent graft and a patent distal bare stent.
胸主动脉瘤腔内治疗后 10 个月，15 岁女性因胸痛、头痛和下肢无力入院。紧急 CT 显示由于移植物内血栓形成，在胸段支架移植物与原生胸段的远端交界处几乎完全阻塞性狭窄。随后患者出现肺水肿并伴有无尿。成功进行了紧急血管成形术和使用镍钛诺裸支架的支架置入术。桡动脉和股动脉之间的血压梯度从 100mmHg 降至 25mmHg。周围灌注不足的征象逐渐消退，肾功能恢复正常。患者在 12 天后出院。进行了 1 个月的皮下抗凝治疗（联合使用单剂量抗血小板治疗）。随访 2 个月后，患者无症状，CT 扫描显示支架移植物通畅，远端裸支架通畅。
