Račytė Austėja, Arzola Luis H, Wanhainen Anders, Asciutto Giuseppe, Kuzniar Marek, Mani Kevin
Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
J Vasc Surg Cases Innov Tech. 2024 Jun 5;10(5):101550. doi: 10.1016/j.jvscit.2024.101550. eCollection 2024 Oct.
In-situ laser fenestration (ISLF) has been described as a viable option for urgent thoracic aortic aneurysm cases involving supra-aortic vessels. There are, however, limited data on its durability. Here, we present a case of a 70-year-old man with a symptomatic 13-cm thoracic aortic aneurysm extending proximally to the origin of the left subclavian artery (LSA). Emergent thoracic endovascular aortic repair with chimney stenting of the left common carotid artery and ISLF for the LSA was successfully performed. During the follow-up, a compression of the bridging stent to the LSA progressed to a stent fracture needing realignment. Despite ISLF's reported technical success, this case highlights the risk of bridging stent complications, emphasizing the need for a close follow-up.
原位激光开窗术（ISLF）已被描述为涉及主动脉弓上血管的紧急胸主动脉瘤病例的一种可行选择。然而，关于其耐久性的数据有限。在此，我们报告一例70岁男性患者，患有一个有症状的13厘米胸主动脉瘤，近端延伸至左锁骨下动脉（LSA）起源处。成功实施了紧急胸主动脉腔内修复术，对左颈总动脉采用烟囱式支架置入术，并对LSA进行了ISLF。在随访期间，桥接支架对LSA的压迫进展为支架断裂，需要重新调整。尽管ISLF报告有技术上的成功，但该病例突出了桥接支架并发症的风险，强调了密切随访的必要性。
