Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Endovascular Treatment of Aortic Dissection due to Suture Line Dehiscence after Aortic Graft Replacement for Type A Aortic Dissection: A Report of Two Cases

A형 대동맥박리의 대동맥 이식편 치환술 후 봉합선 열개의 혈관내 치료: 2건의 증례 보고

  • Woo Jin Shim (Department of Radiology, Daegu Catholic University Medical Centre, Catholic University of Daegu College of Medicine) ;
  • Young Hwan Kim (Department of Radiology, Daegu Catholic University Medical Centre, Catholic University of Daegu College of Medicine)
  • 심우진 (대구가톨릭대학교 의과대학 대구가톨릭대학교병원 영상의학과) ;
  • 김영환 (대구가톨릭대학교 의과대학 대구가톨릭대학교병원 영상의학과)
  • Received : 2023.11.23
  • Accepted : 2024.01.25
  • Published : 2024.05.01
Download PDF
⟨ Previous Next ⟩

Abstract

Aortic anastomotic leak is an uncommon complication after ascending aortic replacement for acute aortic dissection. Redo-surgery is the traditional standard treatment despite high mortality and morbidity. Recently, endovascular treatment has been attempted as an alternative approach in a few case reports. Here, we present two cases of aortic anastomotic leak due to suture line dehiscence after aortic graft replacement for type A aortic dissection, which were successfully treated by coil with subsequent N-butyl cyanoacrylate embolization and an AmplatzerTM vascular plug.

대동맥 문합부 누출은 급성 대동맥 박리의 치료인 상행 대동맥 치환술 후 발생할 수 있는 흔하지 않은 합병증이다. 대동맥 문합부 누출의 치료로는 재수술이 전통적인 치료 방법으로 추천되나 높은 사망률과 이환율을 보인다. 최근에는 몇 건의 증례 보고에서 중재 시술이 대안적인 접근방식으로 시도되고 있다. 이에 저자들은 A형 대동맥박리의 치료인 대동맥 이식편치환술 후 봉합선 열개에 의한 대동맥 문합부 누출을 코일과 N-butyl cyanoacrylate로 색전술을 시행한 증례와 혈관마개로 성공적으로 치료한 증례를 보고하고자 한다.

Keywords

References

  1. Tanaka H, Okada K, Kawanishi Y, Matsumori M, Okita Y. Clinical significance of anastomotic leak in ascending aortic replacement for acute aortic dissection. Interact Cardiovasc Thorac Surg 2009;9:209-213
  2. Kobuch R, Hilker M, Rupprecht L, Hirt S, Keyser A, Puehler T, et al. Late reoperations after repaired acute type A aortic dissection. J Thorac Cardiovasc Surg 2012;144:300-307
  3. Wu W, Ke Y, Zhao H, Huang L, Pu J. Trans-catheter closure of aortic anastomosis leak after aortic replacement: classifications and techniques. J Thorac Dis 2020;12:4883-4891
  4. Bouassida I, Meyrignac O, Marcheix B, Revel-Mouroz P, Rousseau H. Treatment of postoperative distal anastomotic endoleak with the amplatzer vascular plug II in chronic aortic arch dissection: a case report. J Thorac Cardiovasc Surg 2018;155:e7-e10
  5. Pu J, Huang L, Wu W. Transcatheter closure of anastomotic leakage after aortic surgery for type A dissection with the amplatzer duct occluder II. Cardiovasc Intervent Radiol 2017;40:1274-1277
  6. Norgaard A, Andersen LI, Haahr PE, Justesen P. Coil embolization of an anastomotic leak after ascending aorta replacement. Acta Radiol 2008;49:510-512
  7. Hashizume K, Shimizu H, Koizumi K, Inoue S. Endovascular aneurysm repair using the periscope graft technique for thoracic aortic anastomotic pseudoaneurysm. Interact Cardiovasc Thorac Surg 2013;16:553-555
  8. Concistre G, Casali G, Santaniello E, Montalto A, Fiorani B, Dell'Aquila A, et al. Reoperation after surgical correction of acute type A aortic dissection: risk factor analysis. Ann Thorac Surg 2012;93:450-455