Otsuka Ryo, Morikage Noriyasu, Mizoguchi Takahiro, Nagase Takashi, Samura Makoto, Harada Takasuke, Suehiro Kotaro, Hamano Kimikazu
Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
EJVES Vasc Forum. 2020 Mar 9;47:18-21. doi: 10.1016/j.ejvsvf.2020.02.011. eCollection 2020.
Abdominal aortic aneurysm (AAA) concomitant with acute aortic dissection is rare.
An acute type B aortic dissection involving AAA in a 58 year old woman is described. Computed tomography angiography demonstrated that the false lumen of the abdominal aorta including the aneurysm remained patent, secondary to entry sites in the abdominal aorta, bilateral external iliac arteries, and a membrane tear of the left renal artery (LRA). The aneurysm was isolated by endovascular aneurysm repair and LRA stenting; all entry sites were occluded by endovascular treatment that included covered stenting of the LRA. Imaging performed three months after the procedure confirmed complete thrombosis of the false lumen and AAA sac shrinkage.
Endovascular treatment with covered stents is reported as an alternative strategy for treatment of AAA concomitant with acute aortic dissection involving a visceral artery.
腹主动脉瘤(AAA)合并急性主动脉夹层较为罕见。
描述了一名58岁女性发生的累及AAA的急性B型主动脉夹层。计算机断层血管造影显示,包括动脉瘤在内的腹主动脉假腔保持通畅,这是由于腹主动脉、双侧髂外动脉的入口部位以及左肾动脉(LRA)的膜性撕裂所致。通过血管内动脉瘤修复术和LRA支架置入术将动脉瘤隔离;所有入口部位均通过包括LRA覆膜支架置入在内的血管内治疗予以封堵。术后三个月进行的影像学检查证实假腔完全血栓形成且AAA瘤体缩小。
据报道,使用覆膜支架进行血管内治疗是治疗合并累及内脏动脉的急性主动脉夹层的AAA的一种替代策略。