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腔内修复治疗伴主动脉夹层的 Kommerell 憩室

Endovascular Repair for Kommerell Diverticulum With Type A Aortic Dissection.

机构信息

Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Ann Thorac Surg. 2020 Sep;110(3):e217-e219. doi: 10.1016/j.athoracsur.2019.12.070. Epub 2020 Feb 12.

Abstract

Total endovascular repair remains challenging for Kommerell diverticulum with chronic type A aortic dissection. We reported the first total endovascular repair for a Kommerell diverticulum with chronic retrograde type A aortic dissection. We conducted total endovascular repair with a unibody, single-branched, stent-graft combined with the chimney technique for reconstruction of both subclavian arteries. Completion angiography showed complete exclusion of the primary entry tear without endoleak and patency of all stent-grafts, and computed tomographic angiography at follow-up showed significant remodeling of the false lumen. In this case we show that total endovascular repair is feasible and safe in selective patients of this kind.

摘要

累及 Kommerell 憩室的慢性 Stanford A 型主动脉夹层的全腔内修复仍然具有挑战性。我们报告首例累及 Kommerell 憩室的慢性逆行性 Stanford A 型主动脉夹层的全腔内修复。我们采用一体式、单分支、覆膜支架结合烟囱技术完成了全腔内修复,重建了双侧锁骨下动脉。完成造影显示原发破口完全隔绝,无内漏,所有覆膜支架通畅,随访 CT 血管造影显示假腔明显重塑。在这种情况下,我们证明了在这种选择性患者中,全腔内修复是可行和安全的。

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