Application of thoracic endovascular aortic repair in the treatment of ruptured descending thoracic aortic aneurysms
10.3969/j.issn.1008-794X.2024.07.006
- VernacularTitle:胸主动脉腔内隔绝术在破裂性胸降主动脉瘤治疗中的应用
- Author:
Hongjiang ZHU
1
;
Pengpeng ZHAO
;
Feng YAN
;
Changzhen QU
;
Yanbo FU
;
Changtie PENG
Author Information
1. 427000 湖南张家界 张家界市人民医院血管介入外科
- Keywords:
ruptured descending thoracic aortic aneurysm;
thoracic aortic aneurysm;
thoracic endovascular aortic repair;
covered stent
- From:
Journal of Interventional Radiology
2024;33(7):728-732
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of endovascular treatment for ruptured descending thoracic aortic aneurysm(rDTAA),and to summarize the treatment experience.Methods The clinical data of 8 patients with rDTAA,who were admitted to the Department of Vascular Interventional Surgery,Zhangjiajie Municipal People's Hospital of China to receive treatment between January 2016 and June 2023,were retrospectively analyzed.The patients included 4 males and 4 females,with a median age of 70.5 years(61-78 years).Preoperative computed tomography angiography(CTA)was performed in all the 8 patients,and the diagnosis of rDTAA complicated by hematoma in the thoracic cavity and/or mediastinum was confirmed.Emergency thoracic endovascular aortic repair(TEVAR)was carried out in all the 8 patients.Results Complete isolation of the thoracic descending aortic aneurysm was achieved in 6 patients,and 2 of them received reconstruction of left subclavian artery by using chimney stent technique.The remaining two patients had a small amount of type Ⅰa endoleak,which disappeared after implantation of a cuff stent at the proximal site.During hospitalization,one patient died of septic shock caused by thoracic aortic-esophageal fistula,and 3 patients developed respiratory failure after operation,which was recovered after thoracic drainage,anti-infection medication and ventilator-assisted breathing therapy.Two patients developed postoperative ischemic stroke,one of them presented as grade Ⅲ motor muscle weakness on the affected side accompanied by speech impairment,and the another patient presented as grade Ⅳ motor muscle weakness on the affected side accompanied by speech impairment.During the follow-up period,one patient died of sudden chest pain 7 months after surgery,and another patient who had not received chimney stent implantation developed type Ⅰa endoleak 18 months after operation,which disappeared after implantation of a cuff stent at the proximal site.The remaining 5 patients showed good clinical condition during the follow-up period.Conclusion For the treatment of rDTAA,TEVAR is clinically safe and effective.
