Wolfers Matthew P, Yu Qian, Montorfano Lisandro, Bordes Stephen J, King Terry
General Surgery, Cleveland Clinic Florida, Weston, USA.
Surgical Anatomy, Tulane University School of Medicine, New Orleans, USA.
Cureus. 2021 Mar 18;13(3):e13971. doi: 10.7759/cureus.13971.
We discuss a rare case of acute Type A thoracic aortic dissection (TAAD) following endovascular aneurysm repair (EVAR) of a common iliac artery aneurysm, which likely resulted from complications due to aberrant anatomy. Valve replacement, ascending aortic arch graft, and entry tear suture repair were necessary to contain the TAAD. Postoperative computed tomography with angiography (CTA) demonstrated stable disease, and the patient remained asymptomatic. Open and endovascular repair of the descending abdominal aorta was avoided. Few cases in the literature report TAAD following EVAR. Detection and repair of the entry site was crucial for containing the TAAD.
我们讨论了一例罕见的急性A型胸主动脉夹层(TAAD)病例,该病例发生在髂总动脉瘤腔内修复术(EVAR)之后,可能是由异常解剖结构引起的并发症所致。为控制TAAD,需要进行瓣膜置换、升主动脉弓移植和入口撕裂缝合修复。术后计算机断层扫描血管造影(CTA)显示病情稳定,患者仍无症状。避免了对腹主动脉降部进行开放和腔内修复。文献中很少有关于EVAR术后发生TAAD的病例报道。检测和修复入口部位对于控制TAAD至关重要。