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在复杂的B型大动脉剖析的混合方法后,动脉-关节-关节旁路感染
Pasqualino Sirignano1, Alberto Signore2, Miriam Lichtner3
1Vascular and Endovascular Surgery Unit, Sant'Andrea Hospital of Rome, Department of General and Specialistic Surgery, "Sapienza" University of Rome, Rome, Italy.
JACC. Case reports
|November 28, 2025
概括
混合胸腔内血管大动脉修复 (TEVAR) 后的血管移植感染很罕见,但致命. 这一案例凸显了对这些严重并发症的早期诊断和积极的,多学科的管理的迫切需要.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 血管外科 血管外科
背景情况:
- 混合胸腔内血管大动脉修复 (TEVAR) 是复杂的B型大动脉剖析的常见治疗方法.
- 血管移植感染是TEVAR的已知,尽管不常见的并发症.
- 关节下关节绕道 (CSB) 有时用于混合TEVAR手术.
研究的目的:
- 为了说明混合TEVAR之后的血管移植感染的诊断和管理挑战.
- 为了强调与混合TEVAR后的CSB感染相关的罕见性和高死亡率.
- 质疑CSB的常规使用,转而采用替代技术.
主要方法:
- 一个57岁的男性患者的病例报告,患有复杂的B型大动脉剖析,接受了混合TEVAR和CSB的治疗.
- 详细描述患者表现的移植感染,诊断工作和随后的干预措施.
- 关于混合TEVAR后血管移植感染的文献综述.
主要成果:
- 患者在手术后4个月在CSB部位发生了对甲素敏感的金黄色葡萄球菌感染.
- 尽管进行了多次干预,包括移植摘除和大动脉修复,但患者因大动脉-食道囊而死亡.
- 文献审查证实,混合TEVAR后CSB移植的感染很少发生,但与高死亡率有关.
结论:
- 混合TEVAR后的血管移植感染,特别是涉及CSB,很少见,但死亡率很高.
- 通过多式成像早期诊断和迅速,积极,多学科的管理对于改善结果至关重要.
- 替代技术的出现可能需要重新评估CSB在混合TEVAR中的常规使用.
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