Wariishi Seiichiro, Fujimoto Eiki, Kano Masashi, Kinoshita Hajime, Chikugo Fumio
Department of Cardiovascular Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan.
Kyobu Geka. 2020 Jun;73(6):449-452.
A 69-year-old man developed sudden-onset chest and back pain and was brought to our hospital. Enhanced computed tomography (CT) revealed acute Stanford type B aortic dissection extending from the distal aortic arch to a 72 mm abdominal aortic aneurysm( AAA). The acute phase was managed by antihypertensive therapy, and the patient was followed up. Twenty days after the onset of aortic dissection, entry closure of aortic dissection by thoracic endovascular aortic repair and abdominal aorta replacement were performed simultaneously. Aorta remodeling was confirmed by postoperative CT, and the patient's postoperative course was uneventful. In the treatment of patients with acute aortic dissection and AAA, surgical intervention timing and strategy must be considered carefully.
一名69岁男性突发胸痛和背痛，被送至我院。增强计算机断层扫描（CT）显示急性斯坦福B型主动脉夹层，从主动脉弓远端延伸至72毫米的腹主动脉瘤（AAA）。急性期采用降压治疗，并对患者进行随访。主动脉夹层发病20天后，同时进行了胸段血管腔内主动脉修复术封闭主动脉夹层入口和腹主动脉置换术。术后CT证实主动脉重塑，患者术后恢复顺利。在治疗急性主动脉夹层和AAA患者时，必须仔细考虑手术干预时机和策略。
