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由于B型急性大动脉解剖导致内移植崩而导致双边下肢缺血的病例
Wakiko Hiranuma1, Tadanori Minagawa1, Takuya Shimizu1
1Department of Cardiovascular Surgery Tohoku Medical and Pharmaceutical University Sendai Miyagi Japan.
Clinical case reports
|November 25, 2024
概括
在大动脉剖析修复后内移植的崩可能导致肢体缺血. 这一案例突出显示了对 Endovascular Aortic动脉瘤修复后出现并发症的患者,通过旁路和开放修复的成功治疗.
科学领域:
- 血管外科 血管外科
- 血管内干预 血管内干预
- 大动脉疾病 大动脉疾病
背景情况:
- 内移植塌是内血管大动脉动脉瘤修复 (EVAR) 后的一个罕见但严重的并发症.
- 急性大动脉解剖可能导致影响大动脉修复装置的二次并发症.
研究的目的:
- 报告一种双边下肢缺血病例,由B型急性大动脉解剖 (TBAD) 引起的内移植崩引起.
- 讨论这种罕见并发症的治疗策略.
主要方法:
- 一名70岁的男性患者有腹腔大动脉动脉瘤 (AAA) EVAR病史,出现肢体缺血症状.
- 诊断成像,包括对比度增强的CT,确定了内移植崩和大动脉剖析.
- 最初的治疗涉及尾双绕道,随后由于持续的内移植崩而进行开放的AAA修复.
主要成果:
- 患者经历了内移植崩和TBAD后的双边下肢缺血.
- 轴双旁路提供了最初的四肢救援.
- 随后的开放AAA修复成功地解决了持续的内移植崩和虚假光线 perfusion.
结论:
- 由于TBAD导致的内移植崩是一个关键的并发症,需要仔细管理.
- 治疗应该是个性化的,外解剖学重血管化是一个可行的选择.
- 为了获得最佳的结果,可能需要采用多阶段方法.
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