Kumagai Kunitaka, Hiraoka Arudo, Chikazawa Genta, Yoshitaka Hidenori
Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, Okayama, Okayama, Japan.
Ann Vasc Dis. 2023 Jun 25;16(2):142-145. doi: 10.3400/avd.cr.22-00075.
Mesenteric malperfusion is a fatal complication of acute aortic dissection, which should rapidly be repaired. However, the optimal treatment strategy remains controversial in patients with type A aortic dissection. We report on a case with aortic bare stenting for visceral and lower limb malperfusion prior to the proximal repair. The visceral and limb reperfusion was obtained after aortic bare stenting and proximal repair was successfully performed. This technique can be an alternative option for visceral malperfusion due to type A aortic dissection. However, careful patient selection is required considering the risk of new dissection and rupture.
肠系膜灌注不良是急性主动脉夹层的一种致命并发症,应迅速进行修复。然而,对于A型主动脉夹层患者,最佳治疗策略仍存在争议。我们报告一例在近端修复前采用主动脉裸支架植入术治疗内脏和下肢灌注不良的病例。主动脉裸支架植入术后实现了内脏和肢体再灌注,并成功进行了近端修复。对于A型主动脉夹层所致的内脏灌注不良,该技术可作为一种替代选择。然而,考虑到新的夹层和破裂风险,需要谨慎选择患者。