Hojo Ryuji, Nakashima Atsuhiro, Teshima Eiichi, Tominaga Osamu, Murata Yoshisuke, Higuchi Shinya, Masuda Munetaka, Tominaga Ryuji
Department of Cardiovasucular Surgery, Fukuoka Wajiro Hospital, Fukuoka, Japan.
Kyobu Geka. 2022 Nov;75(12):999-1002.
The patient was a 60-year-old woman who underwent thoracoabdominal aorta replacement for type B aortic dissection three years ago and aortic root replacement and total aortic arch replacement due to asymptomatic type A aortic dissection two years previously. Her clinical course was uneventful until follow-up computed tomography (CT) disclosed anastomotic insufficiency in the innominate artery and left main coronary artery stenosis owing to hematoma. Emergent percutaneous coronary intervention and stent graft insertion into the innominate artery were performed successfully. Seven months later, however, CT scan revealed a perforation in the posterior wall of the artificial graft damaged by the edge of the implanted stent graft. The patient underwent open surgery and perforation of artificial graft was sutured and redundant stent graft edge was resected. Artificial graft damage by stent graft placement is rare to date, but may increase in the future in accordance with broader application of endovascular treatment.
该患者为一名60岁女性，三年前因B型主动脉夹层接受胸腹主动脉置换术，两年前因无症状A型主动脉夹层接受主动脉根部置换术和全主动脉弓置换术。在随访计算机断层扫描（CT）发现无名动脉吻合口功能不全以及因血肿导致左主冠状动脉狭窄之前，她的临床过程平稳。成功进行了紧急经皮冠状动脉介入治疗并在无名动脉植入了支架移植物。然而，七个月后，CT扫描显示人工血管后壁因植入的支架移植物边缘而受损穿孔。患者接受了开放手术，人工血管穿孔得以缝合，多余的支架移植物边缘被切除。迄今为止，支架移植物放置导致人工血管损伤很少见，但随着血管内治疗的更广泛应用，未来可能会增加。
