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首页> 外文期刊>Journal of endovascular therapy: an official journal of the International Society of Endovascular Specialists >Complex Endovascular Aortic Repair With a Branched Endograft to Revascularize 5 Renovisceral Vessels and an Intercostal Artery in a Marfan Patient
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Complex Endovascular Aortic Repair With a Branched Endograft to Revascularize 5 Renovisceral Vessels and an Intercostal Artery in a Marfan Patient

机译：复杂的血管内主动脉修复与分枝内血血移植物，血运重建5血管和Marfan患者中的肋间动脉

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Purpose: To report a case of thoracoabdominal aortic aneurysm (TAAA) repair treated with a multibranched stent-graft including a prophylactic branch for a large intercostal artery in a Marfan patient at risk for spinal cord ischemia (SCI). Case Report: A 43-year-old man with Marfan syndrome presented with a type IV thoracoabdominal aortic aneurysm (TAAA) and history of multiple previous cardiac and aortic operations over the past 28 years. The maximum diameter of the aneurysm was 60 mm. The patient had 2 right renal arteries and 2 reimplanted segmental arteries (1 occluded). With the goal of preserving both right renal arteries and the large intercostal artery, a 6-branch, custom-made stent-graft was planned and manufactured. Bilateral femoral and right brachial artery access was used. The intercostal artery was catheterized and connected to the retrograde branch from a femoral access. Final angiography and predischarge computed tomography angiography (CTA) showed unimpeded flow to all 6 target vessels. The patient was discharged on postoperative day 10 without clinical signs of SCI. Six-month follow-up CTA demonstrated exclusion of the TAAA and patency of all 6 branches. Conclusion: Multibranched endovascular aortic repair with a branch to a large intercostal artery was technically feasible and clinically successful.
机译：目的：报告用多天角支架治疗的胸腹主动脉瘤（TaAA）修复，包括脊髓缺血（SCI）风险的Marfan患者的大型肋间动脉的预防性分支。案例报告：一名43岁男子患有Marfan综合征的人，介绍了IV型胸腹主动脉瘤（Taaa）和过去28年的先前心脏和主动脉操作的历史。动脉瘤的最大直径为60毫米。患者有2个右肾动脉，2个重生的节段动脉（1个闭塞）。通过保留右肾动脉和大型肋间动脉的目标，计划和制造了6分支定制的支架移植物。使用双侧股骨和右肱动脉接入。肋间动脉是导管插入的，并从股骨通道连接到逆行分支。最终的血管造影和预充电计算断层摄影血管造影（CTA）显示出全部6个目标血管的流动。患者在术后第10天出院，没有SCI的临床迹象。六个月的随访CTA证明了所有6个分支机构的TaaA和Patence。结论：多刺血管内主动脉修复到大型肋间动脉的分支在技术上是可行的，临床成功。

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