Distal False Lumen Occlusion in Aortic Dissection With a Homemade Extra-Large Vascular Plug: The Candy-Plug Technique
Distal False Lumen Occlusion in Aortic Dissection With a Homemade Extra-Large Vascular Plug: The Candy-Plug Technique
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DOI：
10.1583/13-4318.1
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发表时间：
2013-08-01
影响因子：
2.6
通讯作者：
Larena-Avellaneda, Axel
中科院分区：
文献类型：
--
作者：
Koelbel, Tilo;Lohrenz, Christina;Larena-Avellaneda, Axel
目的：报道一种制造特大血管塞的技术，用于阻塞慢性主动脉夹层的大远端假腔。技术：我们在一位58岁的多病男性患者中证实了“糖塞”技术，他有复杂的急性B型主动脉夹层和9厘米的慢性胸腔假腔动脉瘤。患者接受了分阶段修复术，第一步为颈椎去分支手术，第二步为从无名动脉到腹腔动脉的胸血管内主动脉修复术。为了从远端途径闭塞大假腔，在手术台上用限制直径的缝线修改支架移植物，使其包裹成糖果状。将该塞置入假腔，并用标准血管塞封堵剩余的开口。在3个月的随访影像中，胸部假腔动脉瘤仍然完全血栓形成。结论：糖塞技术通过防止远端假腔回流，可以完全闭塞胸腔慢性假腔动脉瘤。
Purpose: To report a technique to create an extra-large vascular plug for occlusion of a large distal false lumen in chronic aortic dissection.Technique: The "candy-plug'' technique is demonstrated in a 58-year-old multimorbid man with a history of complicated acute type B aortic dissection and a 9-cm chronic thoracic false lumen aneurysm. The patient underwent a staged repair with a cervical debranching procedure as a first step and a thoracic endovascular aortic repair from the innominate artery to the celiac artery as a second step. To occlude the large false lumen from a distal route, a stent-graft was modified on-table with a diameter-restricting suture, giving it a wrapped candy-like shape. This plug was deployed into the false lumen, and the remaining opening was occluded with a standard vascular plug. On 3-month follow-up imaging, the thoracic false lumen aneurysm remained completely thrombosed.Conclusion: The candy-plug technique can facilitate complete occlusion of chronic thoracic false lumen aneurysm by prohibiting distal false lumen backflow.