Lobato Armando C, Riscado Lorrane, Simão José Reginaldo, Meirelles Guilherme, Accioly Luiz Antônio, Camacho-Lobato Luciana
Institute of Vascular and Endovascular Surgery of São Paulo, São Paulo, Brazil.
Faculty of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil.
J Vasc Surg Cases Innov Tech. 2022 Jul 16;8(3):514-519. doi: 10.1016/j.jvscit.2022.06.014. eCollection 2022 Sep.
A 63-year-old man had presented for emergency endovascular treatment of acute type B aortic dissection complicated by acute occlusion of the true lumen of the infrarenal aorta and a Crawford type III thoracoabdominal aortic aneurysm. These findings precluded the use of a conventional endovascular approach. A novel technique was developed with the insertion of guidewires through the left femoral and subclavian arteries to deliver stent grafts to cover the dissection entry tear and exclude the thoracoabdominal aortic aneurysm. A femorofemoral bypass was performed to preserve the circulation. The procedure and follow-up course were uneventful. This technique appears to be a promising tool for thoracic endovascular aortic repair in emergency setting. More experience with the method is warranted.
一名63岁男性因急性B型主动脉夹层合并肾下腹主动脉真腔急性闭塞及Crawford III型胸腹主动脉瘤前来接受紧急血管内治疗。这些发现排除了使用传统血管内方法的可能性。开发了一种新技术，通过左股动脉和锁骨下动脉插入导丝，以输送支架移植物来覆盖夹层入口撕裂并排除胸腹主动脉瘤。进行了股股旁路手术以维持循环。手术过程及随访过程均顺利。该技术似乎是紧急情况下胸主动脉腔内修复的一种有前景的工具。有必要积累更多该方法的经验。
