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房间隔缺损封堵器联合覆膜支架治疗既往弹簧圈封堵失败的主动脉夹层动脉瘤:1例报告

Atrial septal defect occluder combined with stent graft for the management of post-dissection aortic aneurysm previously treated with unsuccessful coils: a case report.

作者信息

Wang Qiqi, Wei Haijun, He Chunshui, Liu Yang

机构信息

Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

CVIR Endovasc. 2023 Nov 29;6(1):58. doi: 10.1186/s42155-023-00405-7.

Abstract

BACKGROUND

Although the candy-plug technique has been reported to be useful for the treatment of post-dissection aortic aneurysm, the stent graft needs be to customized to accommodate the size of vascular occluders.

CASE PRESENTATION

We present a case of a persistent false lumen successfully treated with endovascular stent-graft and atrial septal defect occluder in a patient with Stanford Type B dissection. A covered stent graft was implanted into the false cavity through a distal rupture, and an atrial septal defect occluder was inserted into the covered stent to seal of the false cavity. Decreased aneurysmal diameter and false lumen thrombosis were noted by CT scan at 6-month follow-up.

CONCLUSIONS

Our case showed that combined use of a stent graft and atrial septal defect occluder is safe, technically feasible and effective in sealing of the false lumen in post-dissection aortic aneurysm patients with previously failed false lumen thrombosis.

摘要

背景

虽然有报道称糖果塞技术可用于治疗夹层后主动脉瘤,但支架移植物需要定制以适应血管封堵器的尺寸。

病例报告

我们报告一例斯坦福B型夹层患者,通过血管内支架移植物和房间隔缺损封堵器成功治疗持续性假腔。一枚覆膜支架移植物通过远端破裂处植入假腔,然后将房间隔缺损封堵器插入覆膜支架以封闭假腔。6个月随访的CT扫描显示动脉瘤直径减小,假腔血栓形成。

结论

我们的病例表明,对于先前假腔血栓形成失败的夹层后主动脉瘤患者,联合使用支架移植物和房间隔缺损封堵器在封闭假腔方面是安全、技术上可行且有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9888/10686903/3cd9969eb6ae/42155_2023_405_Fig1_HTML.jpg

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