German Aortic Center, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
J Endovasc Ther. 2021 Oct;28(5):804-811. doi: 10.1177/15266028211025038. Epub 2021 Jun 21.
To report endovascular repair of postdissection thoracoabdominal aortic aneurysm (TAAA) in 2 patients with vascular Ehlers-Danlos syndrome (vEDS).
. A 56-year-old vEDS male patient with a 50-mm type III TAAA [history of aortic root repair, hemiarch replacement, and thoracic endovascular aortic repair (TEVAR) for acute type A aortic dissection (TAAD) 7 years ago] was treated by a 2-stage procedure; first, cervical debranching of the left subclavian artery and second TEVAR and t-branch. The postoperative course was uneventful. Follow-up computed tomography angiography (CTA) 3.5 years postoperatively demonstrated aortic remodeling with patency of targeted visceral vessels and no endoleak. . A 47-year-old vEDS male patient presented with a TAAA (diameter of 67 mm). The patient had a history of aortic valve and arch replacement with elephant trunk for acute TAAD, and consequently a TEVAR and candy-plug procedure after a ruptured false lumen (FL) aneurysm of the descending thoracic aorta. He also had a surgical repair by an aorto-bi-iliac graft. Two years later, CTA demonstrated aneurysmal FL dilatation distally to the candy-plug and he was treated with fenestrated EVAR (F-EVAR).
Endovascular repair of postdissection TAAA was feasible and safe with good short-term outcome in 2 patients with vEDS.
报告 2 例血管型埃勒斯-当洛斯综合征(vEDS)患者的胸主动脉夹层后腹主动脉瘤(TAAA)的血管内修复。
一名 56 岁的 vEDS 男性患者,7 年前曾因急性 A 型主动脉夹层(TAAD)行主动脉根部修复、半弓置换和胸主动脉腔内修复术(TEVAR),现患有 50mm 型 III TAAA [病史],行两阶段手术治疗;首先行左锁骨下动脉颈动脉去分支术,其次行 TEVAR 和 T 型分支。术后过程顺利。术后 3.5 年的随访计算机断层血管造影(CTA)显示主动脉重塑,目标内脏血管通畅,无内漏。
一名 47 岁的 vEDS 男性患者,患有 TAAA(直径 67mm)。该患者有急性 TAAD 的主动脉瓣和弓置换伴象鼻手术史,随后在降主动脉破裂假腔(FL)动脉瘤后行 TEVAR 和糖果塞手术。他还接受了腹主动脉-双髂动脉移植物的手术修复。两年后,CTA 显示糖果塞远端的 FL 扩张,行腔内开窗 EVAR(F-EVAR)治疗。
血管内修复血管型埃勒斯-当洛斯综合征(vEDS)患者的胸主动脉夹层后腹主动脉瘤是可行和安全的,短期结果良好。