Saga Toshifumi, Hori Yuto, Mikoshiba Haruki, Urata Masahiro
Department of Cardiovascular Surgery, Shin-Kuki General Hospital, Kuki, Japan.
Kyobu Geka. 2021 Feb;74(2):142-145.
We report a case of a 65-year-old man, who was transported as an emergency case to our institution because of Stanford type B dissection. He received conservative therapy, but follow-up computed tomography(CT) revealed dilatation of descending aorta and low-enhanced range from abdominal aorta to right common iliac artery due to the expansion of the false lumen on day 11 of hospitalization. So, we attempted to perform debranch thoracic endovascular aortic repair (TEVAR), but we could not delivery the stentgraft through occluded right iliac artery. Four days later, we performed hybrid surgery of TEVAR and Y-graft replacement with reconstruction of the left renal artery. Postoperative CT showed no endoleak of TEVAR and ankle brachial pressure index (ABI) showed normal level. He was discharged on the 13th postoperative day.
我们报告一例65岁男性患者，因Stanford B型主动脉夹层作为急诊病例被转运至我院。他接受了保守治疗，但住院第11天的随访计算机断层扫描（CT）显示，由于假腔扩大，降主动脉扩张，从腹主动脉到右髂总动脉出现低强化区域。因此，我们尝试进行去分支胸主动脉腔内修复术（TEVAR），但无法通过闭塞的右髂动脉输送支架移植物。四天后，我们进行了TEVAR与Y型人工血管置换并重建左肾动脉的杂交手术。术后CT显示TEVAR无内漏，踝肱压力指数（ABI）显示正常水平。他在术后第13天出院。
