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用于夹层分离后破裂胸腹主动脉瘤的假腔栓塞和假腔覆膜支架技术

False lumen embolization and false lumen stent-graft techniques for ruptured post-dissection thoracoabdominal aneurysm.

作者信息

Umibe Takumi, Nishiori Hironobu, Ikeuchi Hiroki, Koizumi Shintaroh, Ueda Hideki, Matsumiya Goro

机构信息

Department of Cardiovascular Surgery, Chiba University Hospital, 1-8-1, Inohana, Chuo-Ku, Chiba 286-0041, Japan.

Minami-Senju Hospital, Division of Cardiology, Tokyo, Japan.

出版信息

J Surg Case Rep. 2024 Aug 5;2024(8):rjae478. doi: 10.1093/jscr/rjae478. eCollection 2024 Aug.

DOI:10.1093/jscr/rjae478
PMID:39109373
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11299107/
Abstract

This report details the successful endovascular repair of a ruptured thoracoabdominal aortic aneurysm in a patient with chronic type B aortic dissection. The procedure consisted of thoracic endovascular aortic repair, abdominal endovascular aortic repair, false lumen (FL) embolization with Candy-Plug, and FL stent-graft technique. The approach effectively regulated FL inflow, achieving complete FL closure. The patient was discharged without major complications including spinal cord ischemia or renal failure, and the long-term outcome is also favorable with reduction of the aneurysm size. The follow-up results have shown a reduction in the aneurysm size. This less invasive method could be an option of treatments for post-dissection thoracoabdominal aortic aneurysms, especially in ruptured cases.

摘要

本报告详细介绍了一名慢性B型主动脉夹层患者破裂胸腹主动脉瘤的成功血管内修复。该手术包括胸段血管内主动脉修复、腹段血管内主动脉修复、使用Candy-Plug栓塞假腔（FL）以及FL支架移植物技术。该方法有效调节了FL血流，实现了FL的完全闭合。患者出院时无脊髓缺血或肾衰竭等重大并发症，长期预后也良好，动脉瘤大小减小。随访结果显示动脉瘤大小有所减小。这种侵入性较小的方法可能是夹层后胸腹主动脉瘤治疗的一种选择，尤其是在破裂病例中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7172/11299107/7cfab2dd0a19/rjae478f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7172/11299107/a9c41e7191c8/rjae478f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7172/11299107/42e33f33a66c/rjae478f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7172/11299107/7cfab2dd0a19/rjae478f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7172/11299107/a9c41e7191c8/rjae478f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7172/11299107/42e33f33a66c/rjae478f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7172/11299107/7cfab2dd0a19/rjae478f3.jpg

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本文引用的文献

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J Vasc Surg Cases Innov Tech. 2023 Mar 16;9(2):101157. doi: 10.1016/j.jvscit.2023.101157. eCollection 2023 Jun.
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Equations for Estimating the Predissected Diameter of the Descending Aorta From Computed Tomographic Images at the Onset of Aortic Dissection.基于 CT 图像估算主动脉夹层起始段降主动脉预切开直径的方程。
J Am Heart Assoc. 2018 Jun 26;7(13):e009196. doi: 10.1161/JAHA.118.009196.
3
Surgical Indication for Chronic Aortic Dissection in Descending Thoracic and Thoracoabdominal Aorta.
降主动脉及胸腹主动脉慢性主动脉夹层的手术指征
Circ Cardiovasc Interv. 2017 Feb;10(2). doi: 10.1161/CIRCINTERVENTIONS.116.004292.
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