Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Percutaneous Fenestration and Stent Placement for Aortic Dissection that Relieved Occluded Infrarenal Abdominal Aortic Flow: A Case Report

급성 대동맥박리에서 폐쇄성 콩팥하방 복부대동맥 혈류회복을 위해 시행된 경피적 내막판 천공술과 스텐트 설치술: 증례 보고

  • Cho, Eui-Min (Department of Radiology, Chosun University Hospital) ;
  • Byun, Joo-Nam (Department of Radiology, Chosun University Hospital) ;
  • Kim, Dong-Hun (Department of Radiology, Soonchunhyang University Hospital Bucheon) ;
  • Kim, Yong-Jae (Department of Radiology, Soonchunhyang University Hospital)
  • 조의민 (조선대학교병원 영상의학과) ;
  • 변주남 (조선대학교병원 영상의학과) ;
  • 김동훈 (순천향대학교 부천병원 영상의학과) ;
  • 김용재 (순천향대학교병원 영상의학과)
  • Published : 2011.03.01
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Abstract

Here we report a case of infrarenal abdominal aortic occlusion secondary to Stanford type A acute aortic dissection, which was successfully treated with percutaneous fenestration and aortic stent placement. Adequate flow to the occluded infrarenal abdominal aorta was not restored by means of percutaneous fenestration alone, so an additional procedure, aortic stent placement, was required to buttress the true lumen and fenestra. We discuss ischemic complications of aortic dissection and related percutaneous intervention and review the literature.

저자들은 Stanford A형 급성 대동맥박리에 병발된 콩팥하방 복부대동맥 폐쇄를 보이는 환자에서 경피적 내막판 천공술과 스텐트 설치술을 시행하여 성공적으로 치료한 1예를 보고하고자 한다. 본 증례는 경피적 내막판 천공술만으로는 폐쇄된 콩팥하방 복부대동맥의 혈류가 충분히 회복되지 않아서 진성 내강(true lumen)과 천공부(fenestra)를 지지하기 위한 스텐트 설치술을 시행하였다. 대동맥박리에 동반된 허혈성 합병증과 이에 대한 경피적 중재술 (percutaneous intervention)을 보고한 문헌들을 살펴보고 본 증례와 비교하고자 한다.

Keywords

References

  1. Fann JI, Miller DC. Aortic dissection. Ann Vasc Surg 1995;9:311-323 https://doi.org/10.1007/BF02135293
  2. Williams DM, Brothers TE, Messina LM. Relief of mesenteric ischemia in type III aortic dissection with percutaneous fenestration of the aortic septum. Radiology 1990;174:450-452 https://doi.org/10.1148/radiology.174.2.2136956
  3. Chavan A, Rosenthal H, Luthe L, Pfingsten S, Kutschka I, Easo J, et al. Percutaneous interventions for treating ischemic complications of aortic dissection. Eur Radiol 2009;19:488-494 https://doi.org/10.1007/s00330-008-1141-4
  4. Hartnell GG, Gates J. Aortic fenestration: a why, when, and howto guide. Radiographics 2005;25:175-189 https://doi.org/10.1148/rg.251045078
  5. Slonim SM, Nyman U, Semba CP, Miller DC, Mitchell RS, Dake MD. Aortic dissection: percutaneous management of ischemic complications with endovascular stents and balloon fenestration. J Vasc Surg 1996;23:241-253 https://doi.org/10.1016/S0741-5214(96)70268-9
  6. Slonim SM, Miller DC, Mitchell RS, Semba CP, Razavi MK, Dake MD. Percutaneous balloon fenestration and stenting for lifethreatening ischemic complications in patients with acute aortic dissection. J Thorac Cardiovasc Surg 1999;117:1118-1127 https://doi.org/10.1016/S0022-5223(99)70248-5
  7. Barnes DM, Williams DM, Dasika NL, Patel HJ, Weder AB, Stanley JC, et al. A single-center experience treating renal malperfusion after aortic dissection with central aortic fenestration and renal artery stenting. J Vasc Surg 2008;47:903-911 https://doi.org/10.1016/j.jvs.2007.12.057