{"title":"一例入路复杂的胸主动脉瘤经心尖胸腔内血管修复术","authors":"Yuhei Tokuda, Munehiro Saiki, Tomoya Inoue, Yusuke Kinugasa, Kentaro Tamura, Atsushi Tateishi, Yu Oshima, Kunikazu Hisamochi, Keiji Yunoki","doi":"10.3400/avd.cr.24-00033","DOIUrl":null,"url":null,"abstract":"<p><p>Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is an alternative treatment option for high-risk patients. While conventionally performed via a transfemoral approach, it is sometimes difficult due to poor access routes. We report the case of a 90-year-old man who was incidentally diagnosed with a descending TAA while undergoing computed tomography for esophageal cancer. The patient had undergone Y-graft replacement twice. His Y-graft leg was highly angulated; therefore, a transfemoral approach was considered difficult. Consequently, transapical TEVAR was performed. The postoperative course was uneventful. Transapical TEVAR can be a useful treatment option for TAAs with poor access routes in super-old patients.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"309-312"},"PeriodicalIF":0.6000,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444829/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Case of Transapical Thoracic Endovascular Repair for Thoracic Aortic Aneurysm with a Complicated Access Route.\",\"authors\":\"Yuhei Tokuda, Munehiro Saiki, Tomoya Inoue, Yusuke Kinugasa, Kentaro Tamura, Atsushi Tateishi, Yu Oshima, Kunikazu Hisamochi, Keiji Yunoki\",\"doi\":\"10.3400/avd.cr.24-00033\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is an alternative treatment option for high-risk patients. While conventionally performed via a transfemoral approach, it is sometimes difficult due to poor access routes. We report the case of a 90-year-old man who was incidentally diagnosed with a descending TAA while undergoing computed tomography for esophageal cancer. The patient had undergone Y-graft replacement twice. His Y-graft leg was highly angulated; therefore, a transfemoral approach was considered difficult. Consequently, transapical TEVAR was performed. The postoperative course was uneventful. Transapical TEVAR can be a useful treatment option for TAAs with poor access routes in super-old patients.</p>\",\"PeriodicalId\":7995,\"journal\":{\"name\":\"Annals of vascular diseases\",\"volume\":\"17 3\",\"pages\":\"309-312\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2024-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444829/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of vascular diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3400/avd.cr.24-00033\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3400/avd.cr.24-00033","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/29 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
胸主动脉瘤（TAAs）的胸腔内血管主动脉修复术（TEVAR）是高风险患者的另一种治疗选择。虽然传统上是通过经胸途径进行，但有时由于入路不畅而难以实施。我们报告了一例 90 岁男性患者的病例，他在接受食道癌计算机断层扫描时意外被诊断出患有降支 TAA。患者曾接受过两次 Y 型移植物置换术。他的 Y 型移植物腿角度很大，因此经股动脉入路被认为是困难的。因此，患者接受了经心尖 TEVAR 手术。术后恢复顺利。经心尖 TEVAR 是治疗超高龄患者入路不畅的 TAAs 的有效方法。
A Case of Transapical Thoracic Endovascular Repair for Thoracic Aortic Aneurysm with a Complicated Access Route.
Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is an alternative treatment option for high-risk patients. While conventionally performed via a transfemoral approach, it is sometimes difficult due to poor access routes. We report the case of a 90-year-old man who was incidentally diagnosed with a descending TAA while undergoing computed tomography for esophageal cancer. The patient had undergone Y-graft replacement twice. His Y-graft leg was highly angulated; therefore, a transfemoral approach was considered difficult. Consequently, transapical TEVAR was performed. The postoperative course was uneventful. Transapical TEVAR can be a useful treatment option for TAAs with poor access routes in super-old patients.
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