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急诊桥接胸主动脉腔内修复术治疗感染性破裂胸主动脉瘤的疗效

The efficacy of immediate bridging thoracic endovascular aortic repair for ruptured infected thoracic aortic aneurysms.

作者信息

Ito Hideki, Mutsuga Masato, Oshima Hideki, Usui Akihiko

机构信息

Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Cardiac Surgery, Toyota Memorial Hospital, Toyota, Japan.

出版信息

J Vasc Surg Cases Innov Tech. 2019 Apr 30;5(2):152-155. doi: 10.1016/j.jvscit.2018.10.005. eCollection 2019 Jun.

Abstract

Herein we describe four cases of ruptured infected thoracic aortic aneurysm. All patients underwent emergent thoracic endovascular aortic repair to stabilize hemodynamics. After controlling infection, stent graft removal and in situ reconstruction with radical debridement were performed in all but one case. All patients survived during the median 31-month follow-up period, and only one exhibited infection reactivation, which occurred 294 days after initial endoaortic repair. That particular patient underwent open repair. The current cases suggest that emergent bridging endovascular repair for ruptured infected thoracic aortic aneurysm is feasible and, after controlling infection, open repair should be performed as soon as possible.

摘要

在此,我们描述了4例感染性胸主动脉瘤破裂的病例。所有患者均接受了急诊胸主动脉腔内修复术以稳定血流动力学。在控制感染后,除1例患者外,其余患者均进行了支架移植物移除及原位重建并彻底清创。所有患者在中位31个月的随访期内存活,仅1例在初次主动脉腔内修复术后294天出现感染复发,该患者接受了开放修复术。目前的病例表明,对于感染性胸主动脉瘤破裂进行急诊桥接腔内修复是可行的,且在控制感染后应尽快进行开放修复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ed2/6495217/2092d95ea62a/gr1.jpg

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