Dhindsa Yasmeen, DiBartolomeo Alexander, Magee Gregory A, Fleischman Fernando, Han Sukgu M
Division of Vascular Surgery and Endovascular Therapy, Comprehensive Aortic Center, University of Southern California, Los Angeles, CA.
J Vasc Surg Cases Innov Tech. 2023 Aug 9;9(4):101289. doi: 10.1016/j.jvscit.2023.101289. eCollection 2023 Dec.
Subclavian artery coverage is frequently required to achieve an adequate proximal seal during thoracic endovascular aortic repair. The thoracic branch endoprosthesis (TBE; W.L. Gore & Associates) is the first U.S. Food and Drug Administration-approved branched device for thoracic endovascular aortic repair, designed for left subclavian artery incorporation. However, anatomic suitability of the TBE has been shown to be limited. In the present report, we describe a novel technique using the TBE in a sandwich periscope configuration to allow for emergent repair of a ruptured thoracic aortic aneurysm with a highly angulated proximal seal zone and aberrant right subclavian artery.
在胸主动脉腔内修复术中，为了实现足够的近端密封，经常需要覆盖锁骨下动脉。胸部分支血管内支架（TBE；W.L.戈尔公司）是美国食品药品监督管理局批准的首个用于胸主动脉腔内修复的分支装置，设计用于合并左锁骨下动脉。然而，TBE的解剖学适用性已被证明是有限的。在本报告中，我们描述了一种新技术，即使用处于三明治潜望镜配置的TBE，以允许对近端密封区高度成角且右锁骨下动脉异常的破裂胸主动脉瘤进行急诊修复。
