Vyas Yamini, Chung Jane M, Elgudin Yakov L, Cho Jae S
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine, University Hospitals, Harrington Heart and Vascular Institute, Cleveland, OH.
Division of Cardiac Surgery, Department of Surgery, Case Western Reserve University School of Medicine, University Hospitals, Harrington Heart and Vascular Institute, Cleveland, OH.
J Vasc Surg Cases Innov Tech. 2024 Oct 17;11(1):101643. doi: 10.1016/j.jvscit.2024.101643. eCollection 2025 Feb.
Shaggy aorta is severe luminal surface degeneration of the aorta leading to an increased risk of plaque destabilization and embolization to the peripheral or visceral vessel beds. It represents a challenging clinical entity for both endovascular and open repair owing to potential atheroembolization, increased early morbidity and mortality, and poor long-term survival. Patients may be denied repair owing to its high risks. Herein, we present a novel approach to open repair of a juxtarenal abdominal aortic aneurysm with shaggy aorta using moderate hypothermic circulatory arrest with antegrade cerebral perfusion and concurrent flow modification to mitigate the risk of atheroma embolism.
“蓬松主动脉”是指主动脉管腔表面严重退变，导致斑块不稳定及外周或内脏血管床发生栓塞的风险增加。由于存在动脉粥样硬化栓塞的可能性、早期发病率和死亡率增加以及长期生存率低等问题，它对于血管腔内修复和开放修复而言都是一个具有挑战性的临床实体。由于风险高，患者可能无法接受修复手术。在此，我们介绍一种新颖的方法，即采用中度低温体外循环停搏并进行顺行性脑灌注以及同时进行血流改道，以减轻动脉粥样硬化栓塞风险，对合并“蓬松主动脉”的肾旁腹主动脉瘤进行开放修复。
