A Case of Successful TEVAR for Acute Stanford Type A Aortic Dissection with a Thrombosed False Lumen
- VernacularTitle:偽腔血栓閉塞を伴うStanford A型急性大動脈解離に対しRelayPro NBSを用いたzone 3 TEVARが奏功した1例
- Author:
Masato FUSEGAWA
1
;
Naritomo NISHIOKA
1
;
Keita SASAKI
1
;
Shuhei MIURA
1
;
Takahiko MASUDA
1
;
Ryushi MARUYAMA
1
;
Akira YAMADA
1
;
Yoshihiko KURIMOTO
1
;
Shuichi NARAOKA
1
Author Information
- Keywords: acute Stanford type A aortic dissection; TEVAR; RelayPro NBS
- From:Japanese Journal of Cardiovascular Surgery 2023;52(5):335-339
- CountryJapan
- Language:Japanese
- Abstract: In acute Stanford type A aortic dissection, except for some thrombosed false-lumen types, graft replacement is a standard treatment. On the other hand, thoracic endovascular aortic repair (TEVAR) might be considered for high-risk patients with retrograde type A aortic dissection when entry is in the descending aorta, although its efficacy in a case of an extensive thrombosed false lumen without obvious entry is unknown. We report a case of successful zone 3 TEVAR using RelayPro NBS for Stanford type A aortic dissection with a localized CT-enhanced false lumen in the proximal descending aorta. An 83-year-old woman was admitted for acute Stanford type A aortic dissection with a thrombosed false lumen of the ascending thoracic aorta. She was initially treated conservatively because of being a high-risk patient for open surgery. One week after hospitalization, the ascending aorta diameter increased and the false lumen in the proximal descending aorta grew sporadically in a CT image. We suspected that the ascending aorta was enlarged due to a partially patent false lumen of the descending thoracic aorta, and performed zone 3 TEVAR using RelayPro NBS to close a possible entry in the proximal descending aorta even though there was no obvious entry. The patient had a good postoperative course and was discharged 15 days after TEVAR. Shrinkage of the false lumen in the ascending aorta was observed in CT images two months after TEVAR.
