Abstract:
Mycotic thoracic aortic aneurysm (MTAA) is a disease that is difficult to treat and often lethal. Open repair has high morbidity and mortality risks; additionally, thoracic endovascular aneurysm repair (TEVAR) often requires innovative techniques. We report the use of an innominate artery chimney endovascular aneurysm repair (ChEVAR) with carotid-carotid and carotid-left subclavian artery bypass for a time-sensitive Salmonella-related MTAA. A symptomatic type 1a endoleak was discovered and promptly and successfully treated. This report shows that the use of innominate artery ChEVAR to treat MTAA is feasible and safe, although the procedure is rarely performed, even in large series. We hypothesize that prophylactic gutter embolization is a feasible option in view of the high endoleak risks in such cases, although further evidence is required to support this.
摘要:
霉菌性胸主动脉瘤(MTAA)是一种难以治疗且通常致命的疾病。开放式修复具有很高的发病率和死亡率风险;此外,胸腔血管内动脉瘤修复术(TEVAR)通常需要创新技术。我们报告了使用无名动脉烟囱血管内动脉瘤修复术(ChEVAR)与颈动脉-颈动脉和颈动脉左锁骨下动脉旁路术进行时间敏感的沙门氏菌相关MTAA。发现有症状的1a型内漏并迅速成功治疗。本报告表明,使用无名动脉ChEVAR治疗MTAA是可行和安全的,尽管该程序很少执行,即使是大型系列。我们假设预防性沟栓塞是一种可行的选择,因为在这种情况下,内漏风险很高。尽管需要进一步的证据来支持这一点。