PDF(Pubmed)
Abstract：
BACKGROUND: Thoracic endovascular aneurysm repair (TEVAR) is commonly used to treat Stanford type B aortic dissections. However, coexistence of aortic dissection and patent ductus arteriosus (PDA) is an extremely rare phenomenon, and TEVAR alone is insufficient for treatment. Herein, a case of endovascular treatment in a patient with both aortic dissection and PDA is reported.
METHODS: A 31-year-old woman presented to the authors\' hospital with chest pain extending to the back. At presentation, her blood pressure was 130/70 mm Hg. Her father, brother, and uncle were all diagnosed with aortic dissection.
METHODS: Computed tomography (CT) revealed Stanford type B aortic dissection from the aortic arch to the infrarenal abdominal aorta; however, PDA was incidentally identified.
METHODS: TEVAR was immediately performed. Follow-up CT scan performed 2 months later did not reveal any thrombosis or remodeling of the false lumen, and the PDA remained open. Therefore, an additional PDA embolization procedure was performed using the Amplatzer Vascular Plug II via the transvenous route.
RESULTS: On follow-up CT performed 6 months after PDA embolization, successful remodeling, and shrinkage of the false lumen were observed, and PDA closure was confirmed.
CONCLUSIONS: If Stanford type B aortic dissection and PDA coexist, TEVAR alone may not be a sufficient treatment and additional PDA embolization may be required. In the present case, transvenous embolization of PDA using an Amplatzer Vascular Plug II was safe and effective.
METHODS: A 31-year-old woman presented to the authors\' hospital with chest pain extending to the back. At presentation, her blood pressure was 130/70 mm Hg. Her father, brother, and uncle were all diagnosed with aortic dissection.
METHODS: Computed tomography (CT) revealed Stanford type B aortic dissection from the aortic arch to the infrarenal abdominal aorta; however, PDA was incidentally identified.
METHODS: TEVAR was immediately performed. Follow-up CT scan performed 2 months later did not reveal any thrombosis or remodeling of the false lumen, and the PDA remained open. Therefore, an additional PDA embolization procedure was performed using the Amplatzer Vascular Plug II via the transvenous route.
RESULTS: On follow-up CT performed 6 months after PDA embolization, successful remodeling, and shrinkage of the false lumen were observed, and PDA closure was confirmed.
CONCLUSIONS: If Stanford type B aortic dissection and PDA coexist, TEVAR alone may not be a sufficient treatment and additional PDA embolization may be required. In the present case, transvenous embolization of PDA using an Amplatzer Vascular Plug II was safe and effective.
摘要：
背景：胸腔血管内动脉瘤修复术（TEVAR）通常用于治疗StanfordB型主动脉夹层。然而,主动脉夹层与动脉导管未闭(PDA)共存是一种极为罕见的现象,仅TEVAR不足以治疗。在这里，报告1例同时患有主动脉夹层和PDA的患者接受血管内治疗的病例.
方法：一位31岁的妇女出现在作者的医院，胸痛延伸到背部。在介绍时,她的血压为130/70mmHg。她的父亲,兄弟,和叔叔都被诊断为主动脉夹层。
方法：计算机断层扫描（CT）显示从主动脉弓到肾下腹主动脉的StanfordB型主动脉夹层；然而，PDA是偶然发现的。
方法：立即进行TEVAR。2个月后进行的随访CT扫描未发现任何血栓形成或假腔重塑，PDA保持开放。因此,通过经静脉途径使用Amplatzer血管栓塞II进行了额外的PDA栓塞手术.
结果：在PDA栓塞后6个月进行随访CT检查，成功的重塑，并观察到假腔的收缩，并确认PDA关闭。
结论：如果StanfordB型主动脉夹层和PDA共存，单独的TEVAR可能不是足够的治疗方法，可能需要额外的PDA栓塞。在目前的情况下,使用Amplatzer血管栓塞II经静脉栓塞PDA是安全有效的.
方法：一位31岁的妇女出现在作者的医院，胸痛延伸到背部。在介绍时,她的血压为130/70mmHg。她的父亲,兄弟,和叔叔都被诊断为主动脉夹层。
方法：计算机断层扫描（CT）显示从主动脉弓到肾下腹主动脉的StanfordB型主动脉夹层；然而，PDA是偶然发现的。
方法：立即进行TEVAR。2个月后进行的随访CT扫描未发现任何血栓形成或假腔重塑，PDA保持开放。因此,通过经静脉途径使用Amplatzer血管栓塞II进行了额外的PDA栓塞手术.
结果：在PDA栓塞后6个月进行随访CT检查，成功的重塑，并观察到假腔的收缩，并确认PDA关闭。
结论：如果StanfordB型主动脉夹层和PDA共存，单独的TEVAR可能不是足够的治疗方法，可能需要额外的PDA栓塞。在目前的情况下,使用Amplatzer血管栓塞II经静脉栓塞PDA是安全有效的.
