Ujihira Kosuke, Kemmochi Reiko, Matsumoto Taiichiro, Tokunaga Noriyuki, Matsumoto Mitsuaki
Department of Cardiovascular Surgery, Tsuyama Central Hospital, Okayama, Japan.
J Vasc Surg Cases Innov Tech. 2025 Jan 15;11(2):101735. doi: 10.1016/j.jvscit.2025.101735. eCollection 2025 Apr.
Type A aortic dissection after thoracic endovascular aortic repair is a life-threatening complication. We present a case of acute type A aortic dissection that occurred after zone 0 stent grafting with a physician-modified inner branch in the ascending aorta. We performed additional endovascular aortic repair using the sandwich technique, which involved placing a chimney stent graft for the brachiocephalic artery and a main aortic stent graft covered by a shortened outer stent graft in the ascending aorta. This technique minimized device diameter, preventing over-dilatation of the true lumen, with sufficient overlap of the stent grafts.
胸主动脉腔内修复术后A型主动脉夹层是一种危及生命的并发症。我们报告一例在升主动脉使用医生改良的内分支进行0区支架植入术后发生的急性A型主动脉夹层病例。我们采用三明治技术进行了额外的胸主动脉腔内修复，该技术包括为头臂动脉放置一个烟囱式支架移植物，并在升主动脉放置一个由缩短的外支架移植物覆盖的主主动脉支架移植物。该技术使器械直径最小化，防止真腔过度扩张，同时支架移植物有足够的重叠。
