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90岁男性有症状的降主动脉瘤的成功血管内修复：病例报告

Successful Endovascular Repair of a Symptomatic Descending Thoracic Aortic Aneurysm in a 90-Year-Old Gentleman: A Case Report.

作者信息

Pande Arindam, Bera Arnab, Debbarma Durlabh, Banerjee Tanmay, Chakraborty Rabin

机构信息

Cardiology, Medica Superspecialty Hospital, Kolkata, IND.

Chest Medicine, Medica Superspecialty Hospital, Kolkata, IND.

出版信息

Cureus. 2025 May 12;17(5):e83940. doi: 10.7759/cureus.83940. eCollection 2025 May.

DOI:10.7759/cureus.83940
PMID:40502900
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12152707/
Abstract

Thoracic aortic aneurysms (TAAs) carry high mortality without intervention, and thoracic endovascular aortic repair (TEVAR) has become a preferred minimally invasive option for high-risk patients. We report a 90-year-old male with prostate cancer and type 2 diabetes, who presented with hemoptysis and left-sided chest pain, initially attributed to lobar pneumonia but later diagnosed as a 40 mm saccular descending TAA compressing the left lung on CT angiography. The patient underwent successful TEVAR with complete symptom resolution and was discharged within five days, demonstrating TEVAR's efficacy in fragile elderly patients. This case highlights TEVAR's advantages over open repair, including reduced morbidity and faster recovery, while underscoring the need for further research on long-term outcomes and anatomical limitations in complex cases to refine patient selection and expand applications.

摘要

胸主动脉瘤（TAAs）若不进行干预，死亡率很高，而胸主动脉腔内修复术（TEVAR）已成为高危患者首选的微创治疗选择。我们报告一例90岁男性患者，患有前列腺癌和2型糖尿病，出现咯血和左侧胸痛，最初归因于大叶性肺炎，但后来在CT血管造影中诊断为一个40毫米的囊状降主动脉瘤压迫左肺。该患者成功接受了TEVAR治疗，症状完全缓解，并在五天内出院，证明了TEVAR在脆弱老年患者中的疗效。该病例突出了TEVAR相对于开放修复术的优势，包括发病率降低和恢复更快，同时强调需要进一步研究复杂病例的长期预后和解剖学局限性，以优化患者选择并扩大应用范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/d2aadf047008/cureus-0017-00000083940-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/443c5e747a57/cureus-0017-00000083940-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/858794add426/cureus-0017-00000083940-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/e08a3f9a1d31/cureus-0017-00000083940-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/c6fa5fbe558d/cureus-0017-00000083940-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/362f969d01ad/cureus-0017-00000083940-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/e1428c37edc9/cureus-0017-00000083940-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/d2aadf047008/cureus-0017-00000083940-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/443c5e747a57/cureus-0017-00000083940-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/858794add426/cureus-0017-00000083940-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/e08a3f9a1d31/cureus-0017-00000083940-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/c6fa5fbe558d/cureus-0017-00000083940-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/362f969d01ad/cureus-0017-00000083940-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/e1428c37edc9/cureus-0017-00000083940-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e0b/12152707/d2aadf047008/cureus-0017-00000083940-i07.jpg

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本文引用的文献

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Long-term outcomes of intervention between open repair and endovascular aortic repair for descending aortic pathologies: a propensity-matched analysis.主动脉病变开放修复与血管内修复术干预的长期结果：倾向匹配分析。
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Current challenges in open versus endovascular repair of ruptured thoracic aortic aneurysm.破裂性胸主动脉瘤开放手术与血管腔内修复术当前面临的挑战。
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Thoracic Aortic Aneurysm Growth: Role of Sex and Aneurysm Etiology.
胸主动脉瘤生长：性别与动脉瘤病因的作用
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