Emad M. Al-Osail, Thomas Le Houérou, Antoine Gaudin, Alessandro Costanzo, Dominique Fabre, Stephan Haulon
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引用次数: 0
Abstract
Iatrogenic type A aortic dissection following thoracic endovascular aortic repair (TEVAR) is a life-threatening complication, with reported incidence rates ranging from 1.3% to 6.8%. Urgent open surgical repair is recommended when this complication occurs. In the present case, surgery was not performed at the onset of symptoms in a 61-year-old female initially treated with TEVAR for an acute type B aortic dissection. She was referred to our center 3 months later with a chronic type A dissection with the primary entry tear located in the arch. In this very fragile patient, we performed an endovascular repair with an arch branched endograft in combination with surgical debranching of the right carotid and left subclavian arteries.Clinical ImpactBranched endograft exclusion of chronic type A dissections resulting from a TEVAR complication is a minimally-invasive approach to consider in very fragile patients to mitigate the potential risks associated with conventional open surgical repair.
胸腔内血管主动脉修复术(TEVAR)后先天性 A 型主动脉夹层是一种危及生命的并发症,据报道其发生率为 1.3% 到 6.8%。出现这种并发症时,建议立即进行开放手术修复。在本病例中,一名 61 岁的女性因急性 B 型主动脉夹层而接受 TEVAR 手术治疗,但在症状出现时并未进行手术。3 个月后,她因慢性 A 型主动脉夹层转诊至本中心,其主要入口撕裂位于主动脉弓。对于这名非常脆弱的患者,我们在进行右颈动脉和左锁骨下动脉去分支手术的同时,使用拱形分支内膜移植进行了血管内修复。临床影响对于因 TEVAR 并发症导致的慢性 A 型夹层,分支内膜移植是一种微创方法,可用于非常脆弱的患者,以降低传统开放手术修复的潜在风险。
期刊介绍:
The Journal of Endovascular Therapy (formerly the Journal of Endovascular Surgery) was established in 1994 as a forum for all physicians, scientists, and allied healthcare professionals who are engaged or interested in peripheral endovascular techniques and technology. An official publication of the International Society of Endovascular Specialists (ISEVS), the Journal of Endovascular Therapy publishes peer-reviewed articles of interest to clinicians and researchers in the field of peripheral endovascular interventions.