복합 대동맥궁 병리에 의한 재발 뇌졸중의 단계적 하이브리드 재혈관 치료
Staged Hybrid Revascularization for Recurrent Stroke in Complex Aortic Arch Pathology
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Aortic arch atherosclerosis is an important source of ischemic stroke. A 73-year-old man had recurrent strokes over 3 months. Imaging showed 76.7% left internal carotid artery stenosis, a bovine arch, a brachiocephalic aneurysm, and a 7 mm high-risk arch plaque. Despite carotid endarterectomy with medical therapy, infarctions recurred. A staged hybrid approach, partial debranching surgery followed by endovascular stent grafting, was performed. No further strokes occurred. This case underscores the importance of evaluating aortic arch pathology and suggests hybrid revascularization can be effective.
Abstract
Aortic arch atherosclerosis is an important source of ischemic stroke. A 73-year-old man had recurrent strokes over 3 months. Imaging showed 76.7% left internal carotid artery stenosis, a bovine arch, a brachiocephalic aneurysm, and a 7 mm high-risk arch plaque. Despite carotid endarterectomy with medical therapy, infarctions recurred. A staged hybrid approach, partial debranching surgery followed by endovascular stent grafting, was performed. No further strokes occurred. This case underscores the importance of evaluating aortic arch pathology and suggests hybrid revascularization can be effective.