Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden.
J Endovasc Ther. 2019 Oct;26(5):691-696. doi: 10.1177/1526602819864308. Epub 2019 Aug 5.
To propose a new simplified technique to occlude multiple segmental arteries for staging and preconditioning of the spinal cord to decrease the potential for spinal cord ischemia after thoracic and thoracoabdominal aortic aneurysm repair. A thoracic stent-graft that flares out to a maximum of 51 mm is deployed in a standard fashion covering all segmental arteries where graft-wall apposition occurs in the first ~20 cm of the aneurysm. The segmental arteries are always closed at their ostia in contrast to selective coil embolization, where there is a risk of more peripheral closure. Follow-up imaging shows thrombus lining the stent-graft-covered portion of the aneurysm and secondary proximal segmental artery occlusion. A new and fast way of staging and preconditioning the spinal cord using a modified stent-graft prior to definitive repair might be an alternative to segmental artery embolization.
为了提出一种新的简化技术来闭塞多个节段性动脉，以对脊髓进行分期和预处理，从而降低胸主动脉和胸腹主动脉瘤修复后脊髓缺血的风险。一种扩张至最大 51mm 的胸主动脉支架移植物以标准方式展开，覆盖所有节段性动脉，其中移植物壁贴附发生在动脉瘤的前 20cm 左右。节段性动脉总是在其开口处闭塞，与选择性线圈栓塞形成对比，后者存在更外周闭塞的风险。随访影像学显示支架移植物覆盖的动脉瘤部分有血栓形成，并且次级近端节段性动脉闭塞。在确定性修复之前，使用改良支架移植物对脊髓进行分期和预处理的新的快速方法可能是节段性动脉栓塞的替代方法。
