Zhang Li, Guan Wei-Kang, Wu Hua-Ping, Li Xiang, Lv Kai-Ping, Zeng Cun-Liang, Song Huan-Huan, Ye Qian-Ling
Department of Vascular Surgery, Dazhou Central Hosptial, Dazhou 0833, Sichuan Province, China.
World J Clin Cases. 2021 Dec 6;9(34):10689-10695. doi: 10.12998/wjcc.v9.i34.10689.
In the context of aortic dissection, increasing pressure within the newly formed false lumen can result in the progressive compression of the true aortic channel. However, true lumen collapse in chronic type B aortic dissection (cTBAD) patients is rare, with few clinical or experimental studies to date having explored the causes of such collapse.
In the present report, we describe a rare case of true-lumen collapse in an 83-year-old patient diagnosed with cTBAD, and we discuss potential therapeutic interventions for such cases. Following thoracic endovascular aortic repair (TEVAR), computed tomography angiography revealed satisfactory stent-graft positioning, no endoleakage, true lumen enlargement, thrombus formation in the false lumen, and slight enlargement of the true lumen distal to the stent-graft. Computational hemodynamic analyses indicated that the wall shear stress and pressure within the false lumen were significantly reduced following TEVAR.
TEVAR treatment of cTBAD patients suffering from proximal true lumen collapse can facilitate some degree of effective remodeling.
在主动脉夹层的情况下，新形成的假腔内压力增加可导致真主动脉通道逐渐受压。然而，慢性B型主动脉夹层（cTBAD）患者的真腔塌陷很少见，迄今为止，很少有临床或实验研究探讨这种塌陷的原因。
在本报告中，我们描述了1例83岁诊断为cTBAD患者发生真腔塌陷的罕见病例，并讨论了此类病例的潜在治疗干预措施。胸主动脉腔内修复术（TEVAR）后，计算机断层扫描血管造影显示支架移植物定位良好，无内漏，真腔扩大，假腔内血栓形成，且支架移植物远端的真腔略有扩大。计算流体动力学分析表明，TEVAR后假腔内的壁面剪切应力和压力显著降低。
对近端真腔塌陷的cTBAD患者进行TEVAR治疗可促进一定程度的有效重塑。
