Sato Hiroki, Sato Noriaki, Takesue Yuki, Kato Kaori, Wakabayashi Takashi, Aoki Kenji
Department of Cardiovascular Surgery, Niigata City General Hospital, Niigata, Japan.
Kyobu Geka. 2021 Nov;74(12):1024-1027.
Although the efficacy of thoracic endovascular aortic repair( TEVAR) for blunt thoracic aortic injury (BTAI) has been reported, the determination of the proper endograft size for TEVAR in BTAI cases is yet to be established. The management of BTAI by TEVAR may not be effective if a wrong endograft size is selected, possibly leading to fatal outcomes. In this case report, a hemodynamically unstable patient with BTAI was saved by TEVAR, and the preoperative and postoperative changes in the aortic diameter were compared. In TEVAR for BTAI, the effects of hemodynamic instability should be considered and the appropriate device size should be determined based on blood pressure, pulse, and inferior vena cava diameter.
尽管已有报道称胸主动脉腔内修复术（TEVAR）治疗钝性胸主动脉损伤（BTAI）的疗效，但在BTAI病例中确定TEVAR合适的血管内移植物尺寸仍有待明确。如果选择了错误的血管内移植物尺寸，TEVAR治疗BTAI可能无效，甚至可能导致致命后果。在本病例报告中，一名血流动力学不稳定的BTAI患者通过TEVAR获救，并比较了术前和术后主动脉直径的变化。在TEVAR治疗BTAI时，应考虑血流动力学不稳定的影响，并根据血压、脉搏和下腔静脉直径确定合适的器械尺寸。
