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逆行颈动脉支架置入术治疗 A 型主动脉夹层合并脑低灌注

Retrograde Carotid Stenting Using Newly Released Venous Stent for Cerebral Malperfusion in Type A Aortic Dissection.

机构信息

Inova Fairfax Hospital, Falls Church, VA, USA.

Fairfax Radiology Associates, Fairfax, VA, USA.

出版信息

J Endovasc Ther. 2022 Jun;29(3):444-450. doi: 10.1177/15266028211050313. Epub 2021 Oct 8.

Abstract

Stanford Type A aortic dissections (TAAD) should be considered for repair, given the involvement of branch vessels which can result in malperfusion, specifically cerebral malperfusion secondary to dissection of the innominate and carotid arteries. This is a case report with a focus on four patients presenting with both acute and chronic symptomatic TAAD, with extension into the innominate and common carotid arteries. In all four cases, the decision to intervene utilizing a hybrid endovascular approach was made to increase perfusion to the brain and alleviate symptoms. Through the use of retrograde carotid stenting utilizing both the VICI venous stent (Boston Scientific, Marlborough, MA) and Abre self-expanding Nitinol stent (Medtronic, Minneapolis, MN) we obtained good results, specifically absence of symptoms and return to normal function of the patients.

摘要

斯坦福 A 型主动脉夹层(TAAD)应考虑进行修复,因为分支血管受累可能导致灌注不良,特别是无名动脉和颈动脉夹层导致的脑灌注不良。这是一个病例报告,重点介绍了 4 名同时患有急性和慢性症状性 TAAD 的患者,病变延伸至无名动脉和颈总动脉。在所有 4 例中,均决定采用杂交血管内治疗方法来增加大脑的灌注并缓解症状。通过使用逆行颈动脉支架置入术,同时使用 VICI 静脉支架(波士顿科学公司,马萨诸塞州马尔伯勒)和 Abre 自膨式镍钛诺支架(美敦力公司,明尼苏达州明尼阿波利斯),我们获得了良好的结果,特别是患者的症状消失,恢复了正常的功能。

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