Satam Keyuree K, Alameddine Dana, Aboian Edouard, Fischer Uwe, Guzman Raul J, Ochoa Chaar Cassius Iyad
Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT.
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale School of Medicine, New Haven, CT.
J Vasc Surg Cases Innov Tech. 2022 Dec 12;9(1):101077. doi: 10.1016/j.jvscit.2022.11.014. eCollection 2023 Mar.
A 60-year-old man presented with chest pain and acute limb ischemia of the right leg. He was found to have a type B aortic dissection with a flap occluding the origin of the right common iliac artery. The dissection flap was fenestrated endovascularly with the placement of a covered stent in the right common iliac artery. After 10 years, the dissection remains stable with a minimal increase in the aorta size. The stent is patent with no lower extremity symptoms or reintervention. Fenestration and stenting of the obstructing flap can be a durable reperfusion strategy for patients with aortic dissection presenting with acute limb ischemia.
一名60岁男性因胸痛和右下肢急性肢体缺血就诊。检查发现他患有B型主动脉夹层，夹层瓣阻塞了右髂总动脉起始部。通过血管腔内开窗术，在右髂总动脉内植入了覆膜支架。10年后，夹层保持稳定，主动脉大小仅有轻微增加。支架通畅，无下肢症状，也无需再次干预。对于因急性肢体缺血而出现主动脉夹层的患者，对阻塞瓣进行开窗和支架置入术可能是一种持久的再灌注策略。
