PDF(Pubmed)
Abstract：
Addressing proximal complications that arise after endovascular aortic repair for type B aortic dissection, such as type Ia endoleaks, \"bird-beaking\" of the thoracic endovascular aortic repair (TEVAR) stent, retrograde type A dissection, and postdissection aneurysms, bears considerable complexities. We present a novel and safe method for open arch repair that can ensure a secure and efficient approach for TEVAR complications. The key element of the operative technique is approximating the grafted stent portion to the aortic wall and the arch prosthesis. The technique has successfully been implemented in 11 patients, who received secondary open arch repair from 2019 to 2022 after TEVAR for type B dissection. Our objective is not only to introduce this reliable concept but also to provide a comprehensive demonstration of its advantages and disadvantages compared with currently used open treatment methods and discuss patient outcomes after secondary open arch repair.
摘要：
解决B型主动脉夹层血管内修复术后出现的近端并发症，如Ia型内漏，胸主动脉腔内修复术（TEVAR）支架的“鸟嘴”，逆行A型夹层,和夹层后动脉瘤，具有相当大的复杂性。我们提出了一种新颖且安全的方法来进行开放式足弓修复，可以确保TEVAR并发症的安全有效方法。手术技术的关键要素是使移植的支架部分接近主动脉壁和足弓假体。该技术已在11名患者中成功实施，在TEVAR进行B型解剖后，于2019年至2022年接受了二次开放足弓修复。我们的目标不仅是介绍这一可靠的概念，而且还提供与当前使用的开放式治疗方法相比的优点和缺点的全面证明，并讨论二次开放式足弓修复后的患者预后。
