대동맥박리에서 가강에 의해 장골동맥 폐색시 좌측 상완동맥을 통한 스텐트 시술
Type B Aortic Dissection with Malperfusion of Both Common Iliac Arteries That Underwent Stent Placement Using the Left Brachial Approach
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초록
합병증을 동반한 급성 하행대동맥박리(acute complicated descending aortic dissection)는 치료하지 않을 경우 초기 사망률이 매우 높은 질환이다[1]. 특히 가강(false lumen)에 의해 진강(true lumen)이 눌려 상장간막동맥(superior mesenteric artery), 복강동맥(celiac trunk), 신장동맥(renal artery), 하지로 가는 동맥이 눌려져서 장, 신장, 간, 하지에 허혈(ischemia)이 발생하는관류 장애(malperfusion)를 동반하는 하행대동맥박리(descending aortic dissection)의 경우 종종 생명을 위협하는데 관류 장애는 하행대동맥박리의 21%에서 나타나며, 관류 장애가 동반된 하행대동맥박리의 병원내 사망률은 46%까지 보고되고 있다[2].
Abstract
Malperfusion syndrome is a complication of acute descending aortic dissection (DAD) and it is associated with a poor clinical outcome. Surgical treatment for it has a high rate of mortality. Thoracic endovascular aortic repair (TEVAR) for DAD with malperfusion syndrome has resulted in good clinical outcomes. However, when both common iliac arteries are compromised by a false lumen, it is impossible to conduct TEVAR because there is no accessible artery. We successfully treated a case of DAD with malperfusion syndrome in which both common iliac arteries were compromised by placing stents in both arteries using the left brachial approach.
참고문헌 (7)
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