医学
支架
外科
放射科
主动脉夹层
肠系膜上动脉
主动脉瘤
动脉瘤
管腔(解剖学)
血管造影
肾动脉
解剖(医学)
肠系膜下动脉
截瘫
右肾动脉
主动脉
肾
内科学
脊髓
精神科
作者
Eric L.G. Verhoeven,Kosmas I. Paraskevas,Kyriakos Oikonomou,Ozan Yazar,W. Ritter,Karin Pfister,Piotr Kasprzak
摘要
To present our initial experience treating post-dissection thoracoabdominal aneurysms with fenestrated and branched grafts.Six patients (all men; mean age 62 years, range 44-71) with post-dissection thoracoabdominal aortic aneurysms were selected for treatment with fenestrated and branched grafts. All patients were initially treated with open surgery or endovascular treatment for their acute dissection. In total, 21 visceral arteries were targeted (3 celiac arteries, 6 superior mesenteric arteries, 12 renal arteries).Technical success was achieved in all cases, with no mortality or paraplegia. At completion angiography, all target vessels were patent, and no type I endoleak was seen. A type II endoleak was present in 4 patients, with the false lumen still partially perfused. During follow-up (mean 9 months, range 3-15), no patients died. One targeted renal artery occluded at 1 month. One type Ib endoleak in a left renal artery was successfully treated with additional stenting. Five of the 6 patients had a 6-month follow-up. On abdominal ultrasound, 3 type II endoleaks were still seen. In 2 of these patients, the endoleak was resolved, the false lumen was completely thrombosed, and the maximum aortic diameter had regressed on the 1-year CTA.Although longer follow-up results are needed, treatment with fenestrated and branched stent-grafts seems feasible and may be a promising option for the treatment of chronic post-dissection aortic aneurysms.
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