Haenen Filip W N, Van Der Weijde Emma, Vos Jan-Albert, Heijmen Robin H
Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Ann Vasc Surg. 2019 Aug;59:312.e15-312.e18. doi: 10.1016/j.avsg.2018.12.107. Epub 2019 Apr 19.
Type A aortic dissection is a highly lethal condition, which warrants swift open surgical intervention to prevent death by rupture or malperfusion. The aim is to resect the proximal intimal tear and realign the dissected wall layers. We describe two patients who recently presented in our center with a retrograde type A intramural hematoma and a clear intimal tear distal to the left subclavian artery, that were treated in emergency by endovascular means instead of open surgery, with satisfactory short-term and one-year follow-up results. In conclusion, in selected cases, less invasive thoracic endovascular aortic repair can treat retrograde type A intramural hematoma originating from an intimal tear distal to the left subclavian artery, with good one-year results.
A型主动脉夹层是一种极具致死性的疾病，需要迅速进行开放性手术干预以防止因破裂或灌注不良而死亡。目的是切除近端内膜撕裂处并重新对齐分离的壁层。我们描述了两名近期在我们中心就诊的患者，他们患有逆行性A型壁内血肿，且在左锁骨下动脉远端有明确的内膜撕裂，通过血管内方法而非开放手术进行了急诊治疗，短期和一年的随访结果令人满意。总之，在特定病例中，侵入性较小的胸主动脉腔内修复术可以治疗源自左锁骨下动脉远端内膜撕裂的逆行性A型壁内血肿，一年效果良好。
