Use of open stent grafting for a mycotic aortic arch aneurysm.
Use of open stent grafting for a mycotic aortic arch aneurysm.
复制标题
使用开放支架移植治疗真菌性主动脉弓动脉瘤。
DOI：
10.1016/j.jtcvs.2006.07.030
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
K. Shimizu
中科院分区：
文献类型：
--
作者：
H. Iwaki;Seko Suzuki;T. Yajima;S. Yamauchi;M. Ochi;K. Shimizu
Kato和他的同事首先报道了用于主动脉弓动脉瘤的开放式支架移植，与传统的合成支架相比，它有几个优点。支架置入替代远端吻合降低了手术风险、手术时间、出血和对邻近器官的损伤。治疗真菌性主动脉瘤有两种主要的手术策略：主动脉排除术和解剖外搭桥或原位移植物手术置换，手术切除感染组织，包括动脉瘤。然而，对于手术治疗尚无明确的共识。在真菌性主动脉弓动脉瘤中应用开放式支架移植尚无报道。然而，也有一些报道称，尽管存在活动性感染，但在不手术切除的情况下，血管内支架移植获得了良好的效果。3,4然而，我们放弃了该患者的血管内支架移植，因为主动脉瘤包括左侧锁骨下动脉的起源。
DiscussionOpen stent grafting used for aortic arch aneurysms, first reported by Kato and colleagues, 2 has several advantages over a conventional synthetic replacement. Substitution of a stent graft placement for a distal anastomosis has reduced the operative risk, operative time, bleeding, and injury to adjacent organs. There are 2 main surgical strategies for mycotic aortic aneurysms: aortic exclusion and extra-anatomic bypass or surgical replacement of in situ grafts with a surgical resection of the infected tissue, including the aneurysm. However, there is no definite consensus on the surgical therapy. There have been no reports in which open stent grafting was used in mycotic aortic arch aneurysms. However, there are a few reports in which good results without surgical resection with endovascular stent grafting were obtained in spite of active infections. 3, 4 However, we abandoned the endovascular stent grafting in this patient because the aortic aneurysm included the origin of the left subclavian artery.