Lu Jeffrey, Blitzer David, Pereira Torrellas Gabriel A, Hall Michael, Kang Jeanwan, Toursavadkohi Shahab
Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, MD.
J Vasc Surg Cases Innov Tech. 2022 Oct 31;9(1):101056. doi: 10.1016/j.jvscit.2022.10.014. eCollection 2023 Mar.
Aortic aneurysms (AA) are a common complication in patients with large-vessel vasculitis, such as chronic phase Takayasu arteritis, that often require surgical management to prevent a lethal rupture. Historically, mainstay of treatment for AA in the setting of arteritis was traditional open repair. However, in this case study an alternative surgical approach was devised to successfully treat an extent III thoracoabdominal AA in a patient with a diagnosis of Takayasu arteritis and a complex surgical history that made her high risk for an open surgical intervention. This case study summarizes a hybrid surgical approach that successfully excluded a thoracoabdominal AA and revascularized the superior mesenteric artery and left renal artery, by directly accessing the infrarenal aorta and using a bifurcated abdominal aortic endograft as a two-vessel branched device.
主动脉瘤（AA）是大血管血管炎患者的常见并发症，如慢性期高安动脉炎，通常需要手术治疗以防止致命性破裂。从历史上看，在动脉炎背景下AA的主要治疗方法是传统的开放修复术。然而，在本病例研究中，设计了一种替代手术方法，成功治疗了一名诊断为高安动脉炎且有复杂手术史、接受开放手术干预风险高的Ⅲ型胸腹主动脉瘤患者。本病例研究总结了一种杂交手术方法，该方法通过直接进入肾下腹主动脉并使用分叉型腹主动脉内移植物作为双血管分支装置，成功排除了胸腹主动脉瘤并使肠系膜上动脉和左肾动脉再血管化。
