PDF(Pubmed)
Abstract：
UNASSIGNED: A pseudoaneurysm arising from the side branch of the prosthesis, following ascending aortic replacement, is extremely rare. Re-intervention usually involves open surgery, replacement of the ascending aorta, or ligation of the side branch. Redo surgery with an additional sternotomy carries the risk of cardiac and vascular injuries, and endovascular treatment can reduce such adverse events.
UNASSIGNED: This study describes the successful thoracic endovascular aortic repair (TEVAR) of two cases of pseudoaneurysms arising from the side branch after ascending aortic replacement. Case 1 involved a 79 year old man who underwent ascending aortic replacement and omentopexy for a ruptured tuberculous aortic aneurysm 13 years ago. The pseudoaneurysm was mushroom shaped with a 30 mm protrusion. Case 2 involved an 83 year old man who underwent ascending aortic replacement for Stanford type A acute aortic dissection 11 years ago. The pseudoaneurysm was rod shaped with a 27 mm protrusion. In both cases, the pseudoaneurysm arising from the side branch was not noted on computed tomography (CT) until one year earlier and was first identified at a routine follow up examination. The pseudoaneurysms required surgical repair because of the risk of rupture; however, TEVAR was selected considering the risks of redo surgery and the patients\' ages. It was performed via a femoral artery approach without adverse events using a commercially available thoracic aortic device. Post-operative CT scan showed complete exclusion of the pseudoaneurysm.
UNASSIGNED: Although TEVAR is usually not indicated for ascending aortic pathologies, if there is an anatomical indication and a compatible stent graft, TEVAR for the ascending aorta should be the first choice in patients who are inoperable, at high risk and undergoing redo surgery.
UNASSIGNED: This study describes the successful thoracic endovascular aortic repair (TEVAR) of two cases of pseudoaneurysms arising from the side branch after ascending aortic replacement. Case 1 involved a 79 year old man who underwent ascending aortic replacement and omentopexy for a ruptured tuberculous aortic aneurysm 13 years ago. The pseudoaneurysm was mushroom shaped with a 30 mm protrusion. Case 2 involved an 83 year old man who underwent ascending aortic replacement for Stanford type A acute aortic dissection 11 years ago. The pseudoaneurysm was rod shaped with a 27 mm protrusion. In both cases, the pseudoaneurysm arising from the side branch was not noted on computed tomography (CT) until one year earlier and was first identified at a routine follow up examination. The pseudoaneurysms required surgical repair because of the risk of rupture; however, TEVAR was selected considering the risks of redo surgery and the patients\' ages. It was performed via a femoral artery approach without adverse events using a commercially available thoracic aortic device. Post-operative CT scan showed complete exclusion of the pseudoaneurysm.
UNASSIGNED: Although TEVAR is usually not indicated for ascending aortic pathologies, if there is an anatomical indication and a compatible stent graft, TEVAR for the ascending aorta should be the first choice in patients who are inoperable, at high risk and undergoing redo surgery.
摘要：
未经证实：由假体侧支引起的假性动脉瘤，升主动脉置换术后，极为罕见。再干预通常涉及开放手术，升主动脉置换,或侧分支的结扎。额外的胸骨切开术重做手术会带来心脏和血管损伤的风险，血管内治疗可以减少此类不良事件。
UNASSIGNED：本研究描述了升主动脉置换术后两例由侧支引起的假性动脉瘤的成功胸血管内主动脉修复术（TEVAR）。病例1涉及一名79岁的男子，他在13年前因结核性主动脉瘤破裂而接受了升主动脉置换和网膜固定术。假性动脉瘤是具有30mm突起的蘑菇形。病例2涉及一名83岁的男子，他在11年前因StanfordA型急性主动脉夹层接受了升主动脉置换术。假性动脉瘤是具有27mm突起的杆状。在这两种情况下，由侧支引起的假性动脉瘤直到一年前在计算机断层扫描(CT)上才被发现,并在常规随访检查中首次被发现.由于存在破裂的风险，假性动脉瘤需要手术修复；然而，选择TEVAR时考虑了重做手术的风险和患者的年龄。使用市售的胸主动脉装置通过股动脉入路进行，无不良事件。术后CT扫描显示完全排除假性动脉瘤。
UNASSIGNED：尽管TEVAR通常不用于升主动脉病变，如果有解剖学指征和兼容的支架移植物，升主动脉的TEVAR应该是无法手术的患者的首选，处于高风险并接受重做手术。
UNASSIGNED：本研究描述了升主动脉置换术后两例由侧支引起的假性动脉瘤的成功胸血管内主动脉修复术（TEVAR）。病例1涉及一名79岁的男子，他在13年前因结核性主动脉瘤破裂而接受了升主动脉置换和网膜固定术。假性动脉瘤是具有30mm突起的蘑菇形。病例2涉及一名83岁的男子，他在11年前因StanfordA型急性主动脉夹层接受了升主动脉置换术。假性动脉瘤是具有27mm突起的杆状。在这两种情况下，由侧支引起的假性动脉瘤直到一年前在计算机断层扫描(CT)上才被发现,并在常规随访检查中首次被发现.由于存在破裂的风险，假性动脉瘤需要手术修复；然而，选择TEVAR时考虑了重做手术的风险和患者的年龄。使用市售的胸主动脉装置通过股动脉入路进行，无不良事件。术后CT扫描显示完全排除假性动脉瘤。
UNASSIGNED：尽管TEVAR通常不用于升主动脉病变，如果有解剖学指征和兼容的支架移植物，升主动脉的TEVAR应该是无法手术的患者的首选，处于高风险并接受重做手术。
