Yamamoto Ryuhei, Kaminishi Yuichiro, Konishi Takahiro, Nakajima Tomomi, Abe Tetsuya, Hiramatsu Yuji, Mori Kensaku
Department of Cardiovascular Surgery and Department of Radiology, University of Tsukuba Hospital, Tsukuba, Japan.
Minim Invasive Ther Allied Technol. 2021 Apr;30(2):120-123. doi: 10.1080/13645706.2019.1683031. Epub 2019 Oct 30.
An 83-year-old woman who had undergone total arch replacement for a thoracic aortic aneurysm seven years prior experienced concurrent rupture of second and third branch anastomotic pseudoaneurysms. A stent graft was initially deployed across the pseudoaneurysm from the third branch to the left subclavian artery. Following the left axillary and left carotid arterial bypass, the origin of the second branch was embolized with metallic coils. As a result, both anastomotic pseudoaneurysms were undetectable by both completion angiogram and postoperative CT. By combining surgical and endovascular procedures, ruptured anastomotic pseudoaneurysms after total arch replacement can be repaired without a risky resternotomy.
一名83岁女性，7年前因胸主动脉瘤接受了全弓置换术，现并发第二和第三分支吻合口假性动脉瘤破裂。最初在假性动脉瘤处从第三分支至左锁骨下动脉植入了覆膜支架。在进行左腋动脉和左颈动脉旁路手术后，用金属线圈栓塞了第二分支的起始部。结果，在完成血管造影和术后CT检查中均未发现吻合口假性动脉瘤。通过联合手术和血管内介入治疗，全弓置换术后破裂的吻合口假性动脉瘤无需再次进行风险较大的开胸手术即可修复。
