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慢性腹主动脉夹层,使用新型原位开窗支架型人工血管进行血管腔内治疗。

Chronic abdominal aortic dissection, endovascular treatment using a new Stent-graft for in situ Fenestration.

作者信息

Bertoni Hernan G, Girela German A, Barone Hector D, De Caso Federico, De La Vega Alejandro, Bui Bao T, Maldonado Thomas

机构信息

Department of Interventional Radiology, Fleni Institute, Buenos Aires University, Caba, Argentina.

Department of Cardiovascular Surgery, Laben, Rio Negro, Argentina.

出版信息

CVIR Endovasc. 2021 Jan 29;4(1):19. doi: 10.1186/s42155-021-00208-8.

Abstract

BACKGROUND

Although endovascular treatment of the thoracic aorta (TEVAR) has become an elective procedure for treatment of complicated type B aortic dissection, its role in treating post dissection thoraco-abdominal aortic aneurysm (TAAA), is still limited. This is a case of aortic vascular disease, which reports the use of a new endovascular device.

CASE PRESENTATION

We present the case of a 62 year old male patient with a history of hypertension, active smoker, who presented penetrating descending thoracic aortic ulcer in the setting of a chronic abdominal aortic dissection. The patient was treated using a new stent graft capable of in situ fenestration that allowed crossing the stent-graft membrane, implanting a covered stent to exclude the re-entry at the level of the left renal artery and redirecting the blood flow through the true lumen.

CONCLUSIONS

This case report demonstrates the feasibility of a novel stent-graft concept. Larger studies with longer follow-up are essential to fully evaluate the safety and effectiveness of this new design.

摘要

背景

尽管胸主动脉腔内治疗(TEVAR)已成为治疗复杂性B型主动脉夹层的一种选择性手术,但其在治疗夹层后胸腹主动脉瘤(TAAA)中的作用仍然有限。这是一例主动脉血管疾病病例,报告了一种新型血管内装置的使用情况。

病例介绍

我们报告一例62岁男性患者,有高血压病史,长期吸烟,在慢性腹主动脉夹层背景下出现穿透性降主动脉溃疡。该患者使用了一种能够原位开窗的新型支架移植物进行治疗,该支架移植物允许穿过支架移植物膜,植入覆膜支架以排除左肾动脉水平的再入口,并使血流通过真腔重新定向。

结论

本病例报告证明了一种新型支架移植物概念的可行性。进行更大规模、更长随访时间的研究对于全面评估这种新设计的安全性和有效性至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c0/7846653/f27e2502eaeb/42155_2021_208_Fig1_HTML.jpg

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