左锁骨下动脉-双侧颈外动脉旁路移植术治疗A型主动脉夹层开放修复术后有症状的颈动脉夹层。
Left Subclavian-Bilateral External Carotid Artery Bypass for Symptomatic Carotid Artery Dissection Secondary to Open Repair of Type A Aortic Dissection.
作者信息
Hiranuma Wakiko, Shimizu Takuya, Takeda Miki, Matsuoka Takayuki, Minakawa Tadanori, Miura Makoto, Hayashi Toshiaki, Sasaki Tatsuya, Kawamoto Shunsuke
机构信息
Department of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi, Japan.
Department of Neurosurgery, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi, Japan.
出版信息
Ann Vasc Dis. 2019 Sep 25;12(3):385-387. doi: 10.3400/avd.cr.19-00004.
Symptomatic carotid dissection, secondary to surgical repair of Stanford type A acute aortic dissection (AAD), requires prompt intervention. A 56-year-old man who underwent total arch replacement with frozen elephant trunk for AAD presented with left hemiplegia and unilateral spatial neglect 16 h after the surgery. Cerebral computed tomography (CT) revealed no fresh lesions, and CT angiography showed severe bilateral carotid dissection. The patient's neurological symptoms improved soon after left subclavian-bilateral external carotid artery bypass to correct symptomatic severe right cerebral ischemia. Therefore, this technique can be a good option for symptomatic carotid dissection in selected patients.
继发于斯坦福A型急性主动脉夹层（AAD）手术修复的有症状颈动脉夹层需要及时干预。一名56岁男性因AAD接受了带冰冻象鼻的全弓置换术，术后16小时出现左侧偏瘫和单侧空间忽视。脑部计算机断层扫描（CT）未发现新鲜病变，CT血管造影显示双侧严重颈动脉夹层。在进行左锁骨下-双侧颈外动脉搭桥以纠正有症状的严重右侧脑缺血后，患者的神经症状很快得到改善。因此，对于选定患者的有症状颈动脉夹层，该技术可能是一个不错的选择。
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