Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
Ann Vasc Surg. 2021 Jan;70:566.e15-566.e20. doi: 10.1016/j.avsg.2020.08.005. Epub 2020 Aug 12.
We illustrate the safety and feasibility of the application of fenestrated stent-grafts for the preservation of spinal artery flow during endovascular repair of thoracoabdominal aortic aneurysms (TAAA) in 2 patients deemed high-risk for spinal cord ischemia (SCI). In one case, an unstented fenestration was used in a 78-year-old male treated for distal stent-graft induced new entry tear. In the other case, a fenestration with a bridging stent-graft was used to revascularize a spinal artery in a 66-year-old female with Marfan disease and island patch aneurysm following open TAAA reconstruction. Both procedures were successful without any postoperative neurologic complication. The unstented fenestration led to a type III endoleak that required the relining of the aortic stent-graft 2 years later. The stented spinal fenestration was patent at a 5-year imaging follow-up.
我们在 2 例被认为存在脊髓缺血 (SCI) 高危风险的患者中展示了在胸主动脉瘤 (TAAA) 腔内修复期间应用开窗支架移植物保留脊髓动脉血流的安全性和可行性。在 1 例患者中，对接受远端支架移植物引起的新入口撕裂的 78 岁男性患者使用了非支架开窗。在另 1 例患者中，对马凡综合征和岛状补丁动脉瘤的 66 岁女性患者使用带有桥接支架移植物的开窗来重新血管化脊髓动脉，该患者接受了开放 TAAA 重建。这两个手术均成功进行，术后无神经并发症。非支架开窗导致 III 型内漏，需要 2 年后对主动脉支架移植物进行再衬。支架脊髓开窗在 5 年影像学随访时仍然通畅。
