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0区降落TEVAR (Najuta) 的崩和高级大脑功能障碍的发展
Akito Imai1, Kisato Mitomi2, Masataka Sato2
1Department of Cardiovascular Surgery, Hitachi General Hospital, Ibaraki, Japan - imai.akito.0919@gmail.com.
The Journal of cardiovascular surgery
|April 15, 2024
概括
胸内血管修复 (TEVAR) 期间的支架移植崩很少发生,但致命. 一名患者在TEVAR后经历了Najuta内移植崩,尽管幸存下来,但导致严重的神经缺陷.
科学领域:
- 血管外科 血管外科
- 医疗设备工程 医疗设备工程
- 心血管成像 - 心血管成像
背景情况:
- 胸腔内血管修复 (TEVAR) 是对大动脉动脉瘤的常见治疗方法.
- 虽然存在TEVAR特异性并发症,但支架移植崩是一种罕见但可能致命的事件.
- 大动脉动脉瘤由于复杂的解剖学而存在独特的挑战.
研究的目的:
- 报告一个罕见的Najuta内移植塌的案例,在TEVAR治疗状外围大动脉动脉瘤后.
- 在复杂的大动脉解剖学中强调与半定制内脏移植相关的潜在风险.
- 强调需要对罕见但严重的TEVAR并发症保持警.
主要方法:
- 一名62岁的男性患者使用Gore TAG和Najuta内移植进行了TEVAR治疗,用于状偏弧大动脉动脉瘤.
- 手术后成像 (血管造影和CT) 显示没有直接的并发症,如内脏泄漏或迁移.
- 监测了患者的临床过程,并在事件发生后进行了随访CT.
主要成果:
- 在TEVAR后12天,患者突然崩,CT显示Najuta内移植的完全崩.
- 紧急手术进行了,以移除崩的内移植,并将戈尔TAG接到大动脉.
- 患者幸存下来,但持续不可逆转的上脑功能障碍;制造商只注意到轻微的鸟嘴配置,没有明确的原因.
结论:
- 纳朱塔内移植崩是一种罕见的,严重的并发症,即使没有明显的手术内或直接的术后问题,也可能发生.
- 纳贾塔内移植的半定制性质,设计以符合大动脉形态,可能仍然存在崩的风险.
- 这一案例强调了在TEVAR治疗中考虑罕见并发症和仔细监测患者的重要性,特别是在复杂的大动脉解剖学方面.
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