Jata Bekim, Jahollari Artan, Kojqiqi Arben, Huti Gentian
Department of Invasive Cardiology, American Hospital 3, Tirana, Albania.
Department of Cardio-Vascular Surgery, American Hospital 3, Tirana, Albania.
Int Med Case Rep J. 2020 Aug 25;13:367-370. doi: 10.2147/IMCRJ.S267692. eCollection 2020.
Coarctation associated with a dissected aneurysm is uncommon and has an incidence of less than 1%. There are few reports describing treatment of this condition with stent graft. Challenging as it may be, endovascular treatment of complex cases has become the preferred modality especially when the anatomy is amenable. We describe the case of a 36-year old male, who suffered a car accident and was diagnosed with acute type B aortic dissection (ATBAD). CT-scan revealed a coarctation associated with a large dissected aneurysm (11cm). Complexity of pathology and high risk of rupture required immediate intervention. Open repair necessitates extensive surgery with a considerable risk of morbidity and mortality. We decided to perform an endovascular repair and subsequentially the patient was successfully treated with stent graft deployment, showing durable early-midterm results. Patient remains asymptomatic to this day and CT-scan at 3-year follow-up revealed a reduced and thrombosed aneurysm.
与夹层动脉瘤相关的主动脉缩窄并不常见,发病率低于1%。很少有报道描述用支架移植物治疗这种疾病。尽管复杂病例的血管内治疗可能具有挑战性,但它已成为首选的治疗方式,尤其是在解剖结构适合时。我们描述了一名36岁男性的病例,他遭遇车祸,被诊断为急性B型主动脉夹层(ATBAD)。CT扫描显示主动脉缩窄伴有一个大的夹层动脉瘤(11厘米)。病理复杂性和破裂风险高需要立即干预。开放修复需要进行广泛的手术,有相当高的发病率和死亡率风险。我们决定进行血管内修复,随后患者通过支架移植物植入成功治疗,显示出持久的早期至中期结果。患者至今仍无症状,3年随访时的CT扫描显示动脉瘤缩小并血栓形成。