采用胸段血管腔内动脉瘤修复术治疗腋股旁路闭塞继发的复发性下肢缺血。
Thoracic endovascular aneurysm repair to treat recurrent lower limb ischemia secondary to occlusion of axillofemoral bypass.
作者信息
Tamaki Mototsugu, Kitamura Hideki, Koyama Yutaka, Sawada Koshi, Kawaguchi Yasuhiko, Tokuda Takahiro, Okawa Yasuhide, Konakano Kazuya
机构信息
Department of Cardiovascular Surgery, Nagoya Heart Center, Nagoya, Japan.
Department of Cardiovascular Surgery, Nagoya Heart Center, Nagoya, Japan.
出版信息
Int J Surg Case Rep. 2020;68:190-192. doi: 10.1016/j.ijscr.2020.02.053. Epub 2020 Feb 28.
INTRODUCTION
A case of malperfusion in which the patient presented with aortic dissection is presented.
PRESENTATION OF CASE
A 69-year-old man with an acute aortic dissection (Stanford type B) had lower limb ischemia. Axillary-femoral bypass was performed, and his lower limb ischemia improved. Eight months after the onset of acute aortic dissection, he again had lower limb ischemia. Contrast-enhanced computed tomography showed axillary-femoral bypass occlusion and true lumen collapse, compressed by the increased false lumen pressure in the aorta. Thoracic endovascular aortic repair (TEVAR) was performed for entry closure. His lower limb ischemia was improved by TEVAR.
DISCUSSION
One of the complications of type B aortic dissection is malperfusion. Endovascular therapy is a first step in treating the malperfusion of type B aortic dissection. It is important to seal the entry for the treatment of malperfusion.
CONCLUSION
If there is an entry, it is important to seal it for the treatment of malperfusion.
引言
本文介绍了一例患者出现主动脉夹层伴灌注不良的病例。
病例介绍
一名69岁男性，患有急性主动脉夹层（斯坦福B型），出现下肢缺血。进行了腋股旁路手术，其下肢缺血情况得到改善。急性主动脉夹层发病八个月后，他再次出现下肢缺血。增强计算机断层扫描显示腋股旁路闭塞，真腔塌陷，被主动脉内增大的假腔压力压迫。进行了胸段血管腔内主动脉修复术（TEVAR）以封闭破口。TEVAR术后其下肢缺血情况得到改善。
讨论
B型主动脉夹层的并发症之一是灌注不良。血管内治疗是治疗B型主动脉夹层灌注不良的第一步。封闭破口对于治疗灌注不良很重要。
结论
对于灌注不良的治疗，如有破口，封闭破口很重要。
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