Flap fenestration in treatment of mis-deployment of stent-graft in false lumen of aortic dissection
10.3760/cma.j.issn.1001-8050.2013.3.006
- VernacularTitle:应用主动脉夹层隔膜穿刺破膜技术治疗覆膜支架误置入夹层假腔
- Author:
Ye PAN
;
Jun ZHAO
;
Weiguo FU
;
Jiacai MEI
;
Mingzhe SHAO
;
Jian ZHANG
- Publication Type:Journal Article
- Keywords:
Peritoneum;
Aneurysm,dissecting;
Stents
- From:
Chinese Journal of Trauma
2013;(3):216-220
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate feasibility of flap fenestration in management of the condition that a stent-graft is wrongly deployed in false lumen of aortic dissection.Methods A retrospective analysis was conducted on a case of Stanford type B aortic dissection who was confirmed that the stent-graft had been wrongly deployed in false lumen of aortic dissection by CT angiography (CTA) after endovascular repair.Thereafter,an additional surgical management was carried out.At length,flap fenestration at 2 cm below pre-deployed stent-graft was performed using an Outback catheter so as to link false and true lumens.Successively,another stent-graft was placed via the access to draw blood flow from false lumen back to true lumen and then coil embolization was performed for distal breach of the dissection.Results Surgery was carried out under local anesthesia,with operation duration of 170 minutes and intraoperative blood loss of 350 ml.The chest and back pain disappeared after operation.The patient commenced to take food and take off-bed activity at the very day of operation in absence of paraplegia,visceral ischemia,or other complications.Aortic CTA at postoperative one week showed ideal positioning of stent-graft,fluent blood flow of aorta and major visceral artery,and vanishing of false lumen.Conclusions Flap fenestration at far-end of pre-deployed stent-graft so as to draw blood flow back to true lumen by connecting the new placed stent graft to pre-deployed stent-graft is an effective treatment for mis-deployment of stentgraft in false lumen of aortic dissection.Outback catheter for flap fenestration is characterized by accurate location and high safety.
