Ganapathy Anand V, Cash Jonathan C, Magee Gregory A, Ziegler Kenneth R, Han Sukgu M
Comprehensive Aortic Center, Keck Hospital of USC, University of Southern California, Los Angeles, CA.
J Vasc Surg Cases Innov Tech. 2022 Jun 14;8(3):367-371. doi: 10.1016/j.jvscit.2022.04.015. eCollection 2022 Sep.
We have described a patient with a history of type A-11 dissection repair, who subsequently underwent thoracic endovascular aortic repair with distal bare metal dissection stents (provisional extension to induce complete attachment) and renal artery stenting for malperfusion. During the next 3 years, the thoracoabdominal aorta had continued to enlarge to 6.9 cm, despite false lumen embolization and thoracic endovascular aortic repair extension. Given the continued aortic enlargement, physician-modified fenestrated endovascular aortic repair was performed within the prior aortic and renal stents with successful aneurysm sealing. The results from the present case have illustrated that continued aneurysmal degeneration can occur after provisional extension to induce complete attachment and that subsequent physician-modified fenestrated endovascular aortic repair is feasible.
我们描述了一位曾接受过A型主动脉夹层修复术的患者，该患者随后接受了胸段血管腔内主动脉修复术，使用远端裸金属夹层支架（临时延伸以诱导完全附着）以及肾动脉支架置入术以治疗灌注不良。在接下来的3年里，尽管进行了假腔栓塞和胸段血管腔内主动脉修复术的延伸，但胸腹主动脉仍继续扩大至6.9厘米。鉴于主动脉持续扩大，在先前的主动脉和肾支架内进行了医生改良的开窗式血管腔内主动脉修复术，成功封闭了动脉瘤。本病例的结果表明，在临时延伸以诱导完全附着后，动脉瘤仍可能继续退变，且随后进行医生改良的开窗式血管腔内主动脉修复术是可行的。
