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1例胸腹主动脉瘤合并局限性主动脉夹层伴急性肾缺血和双侧肢体缺血的有效球囊开窗术病例

A Case of Effective Balloon Fenestration for Localized Aortic Dissection Complicated with Acute Renal and Bilateral Limb Ischemia in a Thoracoabdominal Aortic Aneurysm.

作者信息

Imaeda Yusuke, Ishibashi Hiroyuki, Orimoto Yuki, Maruyama Yuki, Mitsuoka Hiroki, Arima Takahiro, Isogai Ako, Matsuyama Katsuhiko, Sugiyama Kayo, Suzuki Kojiro

机构信息

Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan.

Cardiac Surgery, Aichi Medical University, Nagakute, Aichi, Japan.

出版信息

Ann Vasc Dis. 2021 Jun 25;14(2):198-201. doi: 10.3400/avd.cr.21-00023.

Abstract

An 85-year-old man visited our hospital with bilateral leg weakness. Blood tests revealed an abrupt deterioration of renal function. Computed tomography revealed a 53-mm aortic aneurysm at the level of the diaphragm with an aortic dissection after branching of the superior mesenteric artery. An emergency left axillary-left femoral artery bypass surgery was performed to secure blood flow to the kidneys and lower limbs. Five days later, a transcatheter balloon fenestration for the stenosis was performed, and the blood pressure of the infrarenal aorta was improved. Both the dorsal pedis and posterior tibial arteries became palpable, and renal function was improved.

摘要

一位85岁男性因双侧腿部无力前来我院就诊。血液检查显示肾功能急剧恶化。计算机断层扫描显示在膈肌水平有一个53毫米的主动脉瘤,在肠系膜上动脉分支后出现主动脉夹层。进行了紧急左腋-左股动脉搭桥手术,以确保肾脏和下肢的血流。五天后,对狭窄部位进行了经导管球囊开窗术,肾下腹主动脉的血压得到改善。足背动脉和胫后动脉均可触及,肾功能也有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46c6/8241542/c764c33f095f/avd-14-2-cr.21-00023-figure01.jpg

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