Department of Cardiovascular Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Cardiovascular Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.
Vasc Endovascular Surg. 2021 Aug;55(6):551-559. doi: 10.1177/15385744211005664. Epub 2021 Mar 25.
In this retrospective study, we presented the results of Castor single-branched stent-graft in a small series of patients with acute type B aortic syndrome and aberrant right subclavian artery (ARSA).
Between January 2019 and November 2019, 5 patients were diagnosed with acute type B aortic syndrome and ARSA (4 patients with intramural hematoma and ARSA, 1 patient with type B aortic dissection and ARSA). All the patients underwent thoracic endovascular aortic repair (TEVAR) using Castor single-branched stent-graft. In-hospital and 3-month outcomes were collected.
The mean operative time was 116 ± 20.43 minutes (range 90-145). All the TEVAR procedures were successfully performed without conversion to open surgery (100% success rate). All the ARSAs of the 5 patients were revascularized in situ by Castor single-branched stent-grafts. No deaths and complications were observed in the 3-month follow-up. The maximal diameters of diseased aortas in the 4 patients with IMH decreased 3 months after TEVAR. The false lumen in the graft-covered segment was completely thrombosed in the patient with type B aortic dissection.
Castor single-branched stent-graft may be a good choice in treatment of acute type B aortic syndrome and aberrant right subclavian artery.
在这项回顾性研究中,我们展示了 Castor 单分支支架移植物在一小部分急性 B 型主动脉综合征伴右位锁骨下动脉异常(ARSA)患者中的治疗结果。
2019 年 1 月至 2019 年 11 月期间,5 例患者被诊断为急性 B 型主动脉综合征伴 ARSA(4 例为壁内血肿伴 ARSA,1 例为 B 型主动脉夹层伴 ARSA)。所有患者均采用 Castor 单分支支架移植物行胸主动脉腔内修复术(TEVAR)。收集住院期间和 3 个月的结果。
平均手术时间为 116±20.43 分钟(范围 90-145 分钟)。所有 TEVAR 手术均成功完成,无一例转为开放手术(成功率 100%)。5 例患者的所有 ARSAs 均通过 Castor 单分支支架移植物原位再血管化。3 个月随访无死亡和并发症。4 例 IMH 患者的病变主动脉最大直径在 TEVAR 后 3 个月减小。B 型主动脉夹层患者的移植物覆盖段假腔完全血栓形成。
Castor 单分支支架移植物可能是治疗急性 B 型主动脉综合征伴右位锁骨下动脉异常的一种较好选择。