Isoda Ryutaro, Kanaoka Yuji, Watanabe Tatsuya, Ishida Atsuhisa, Kuinose Masahiko, Morita Ichiro
Department of Surgery, Kawasaki Medical School General Medical Center, Okayama, Okayama, Japan.
Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan.
Ann Vasc Dis. 2021 Jun 25;14(2):181-184. doi: 10.3400/avd.cr.21-00035.
A high-risk patient with aortic arch aneurysm, associated with severe calcification of the ascending aorta and iliac arteries, was treated with total debranching and antegrade thoracic endovascular aortic repair (TEVAR) via the ascending aorta. Proximal anastomosis for a triple-branched graft to the ascending aorta was performed without side clamping using the "real chimney technique." After bypassing the supra-aortic branches, a TEVAR was performed in an antegrade fashion through the ascending aorta. This case suggests that the approaches mentioned above should be considered in patients with arch aneurysms and severe calcified degeneration.
一名患有主动脉弓动脉瘤的高危患者，伴有升主动脉和髂动脉严重钙化，接受了全去分支术和顺行性胸主动脉腔内修复术（TEVAR），通过升主动脉进行。使用“真正烟囱技术”在不进行侧支钳夹的情况下，将三分支移植物与升主动脉进行近端吻合。在绕过主动脉弓上分支后，通过升主动脉以顺行方式进行TEVAR。该病例表明，对于患有弓部动脉瘤和严重钙化退变的患者，应考虑上述方法。
