Tsuchida Yuta, Otake Hiroshi, Sanada Junichiro, Gatate Yuko, Miyauchi Tadamasa, Tedoriya Takeo
Department of Cardiovascular Surgery, Ageo Central General Hospital, Ageo, Japan.
Kyobu Geka. 2022 Sep;75(9):693-695.
We report a case of complicated Stanford type B acute aortic dissection with malperfusion to the right leg. The patient received conservative treatment in a previous hospital. However, he complained of pain in the right leg, which had been gradually turning pale. The patient was diagnosed with complicated Stanford type B acute aortic dissection with right leg malperfusion and was transferred to our hospital for treatment. Thoracic endovascular aortic repair (TEVAR) to close the entry to the distal aortic arch was performed, and we embolized the left subclavian artery to prevent type Ⅱ endoleak and to extend the stent-graft landing zone. We implanted a bare stent into the right external iliac artery to enlarge its true lumen. The patient was discharged from our hospital 22 days postoperatively. After the operation, computed tomography( CT) scan showed an aortic false lumen remodeling.
我们报告一例伴有右下肢灌注不良的复杂性斯坦福B型急性主动脉夹层病例。该患者此前在其他医院接受了保守治疗。然而,他主诉右腿疼痛,且右腿逐渐变苍白。该患者被诊断为伴有右下肢灌注不良的复杂性斯坦福B型急性主动脉夹层,并被转至我院治疗。我们进行了胸主动脉腔内修复术(TEVAR)以封闭远端主动脉弓入口,并栓塞了左锁骨下动脉以预防Ⅱ型内漏并扩大覆膜支架锚定区。我们在右髂外动脉植入了裸支架以扩大其真腔。患者术后22天出院。术后计算机断层扫描(CT)显示主动脉假腔重塑。