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采用假腔支架移植物置入术分期进行腔内修复治疗夹层后胸腹主动脉瘤。

Staged endovascular repair of post-dissection thoracoabdominal aortic aneurysm using false lumen stent grafts placement.

作者信息

Nishiori Hironobu, Ueda Hideki, Watanabe Michiko, Kohno Hiroki, Matsuura Kaoru, Inui Tomohiko, Ikeuchi Hiroki, Kanda Tomoyoshi, Ito Chihiro, Yamamoto Hiroaki, Shibata Yusuke, Yamamoto Takashi, Nagahama Maiko, Matsumiya Goro

机构信息

Department of Cardiovascular Surgery, Chiba University Hospital, 1-8-1, Inohana, Chuo-Ku, Chiba City, Chiba 260-8677, Japan.

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

出版信息

J Surg Case Rep. 2025 May 23;2025(5):rjaf336. doi: 10.1093/jscr/rjaf336. eCollection 2025 May.

Abstract

We report a false lumen stent graft technique to close the intimal tears at the visceral segment for post-dissection thoracoabdominal aneurysm after initial thoracic endovascular aortic repair. Following abdominal endovascular aortic repair, a stent graft was then deployed in the false lumen, and successfully closed the intimal tears at the visceral segment. The residual re-entries at the iliac level were closed 2 years after the prior endovascular aortic repair, once a collateral network for spinal cord perfusion had developed, minimizing the risk of spinal cord ischemia. This endovascular strategy successfully reduced a size of post-dissection thoracoabdominal aneurysm.

摘要

我们报告了一种假腔支架移植物技术,用于在初次胸段血管腔内主动脉修复术后,闭合胸腹主动脉瘤内脏段的内膜撕裂口。在腹段血管腔内主动脉修复术后,将一个支架移植物植入假腔,并成功闭合了内脏段的内膜撕裂口。在先前的血管腔内主动脉修复术后2年,当脊髓灌注的侧支循环形成后,髂动脉水平的残余再入口被闭合,从而将脊髓缺血的风险降至最低。这种血管腔内治疗策略成功减小了夹层后胸腹主动脉瘤的大小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f99/12100736/e2a6c59c8920/rjaf336f1.jpg

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