Chait Jesse, Mendes Bernardo C, Johnston Lily E, Shuja Fahad, Oderich Gustavo S, Kalra Manju
Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
Kaiser Permanente, Sacramento, CA.
J Vasc Surg Cases Innov Tech. 2023 Apr 27;9(2):101200. doi: 10.1016/j.jvscit.2023.101200. eCollection 2023 Jun.
Type B aortic dissection (TBAD) in the presence of an existing aortic endograft is a rare, but potentially catastrophic, event. False lumen pressurization and propagation leads to several failure modes. Endograft collapse can lead to spinal cord, visceral, or lower extremity ischemia, and rupture of a previously sealed aneurysm sac is often fatal. A successful treatment strategy must incorporate the patient's symptoms, urgency of intervention, extent of dissection, and the location and status of the existing graft. In this series, we present three cases of TBAD complicating prior endovascular aortic repairs-infrarenal, iliac branched, and thoracoabdominal branched endografts-successfully treated with tailored, hybrid interventions.
在已有主动脉内移植物的情况下发生B型主动脉夹层（TBAD）是一种罕见但可能具有灾难性的事件。假腔受压和扩展会导致多种失败模式。移植物塌陷可导致脊髓、内脏或下肢缺血，而先前已封闭的动脉瘤囊破裂往往是致命的。成功的治疗策略必须综合考虑患者的症状、干预的紧迫性、夹层的范围以及现有移植物的位置和状态。在本系列中，我们介绍了3例TBAD合并先前血管腔内主动脉修复术（肾下、髂支和胸腹分支内移植物）的病例，这些病例通过量身定制的杂交干预措施得到了成功治疗。
