Stent graft 삽입치료 후 발생한 역행성 Stanford A형 대동맥 박리증 1예
Retrograde Stanford type A aortic dissection after endovascular stent graft placement for type B dissection
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초록
대동맥 박리증에 대한 스텐트 그라프트 삽입치료 후의 합병증 중 역행성 A형 대동맥 박리증은 매우 드문 것으로 생각되어 왔으나 이 치명적인 합병증이 최근에 다수 보고되고 있다. 국내에서는 아직 이러한 역행성 대동맥 박리증의 발생에 대한 보고가 없으나 실제로는 상당수 발생하고 있을 것으로 생각되며 그 예방을 위해 환자에 따른 장비 및 장치(device)의 선택, 스텐트 그라프트 설계의 발전 그리고 혈관 내 시술의 표준화 및 안전화가 반드시 필요하다.
Abstract
Endovascular stent graft placement in Stanford type B aortic dissection has increased as a result of the demonstration of its safety and efficacy. Despite the advantage of reduced mortality and morbidity, the mid-to long-term prognosis and possible complications associated with the procedure are a source of concern. Among the many possible complications, retrograde type A dissection after stent grafting for type B dissection is considered rare; however, this life-threatening event appears to be underrecognized. Here, we report a case that converted to open surgery due to a retrograde type A dissection after endovascular stent graft placement for a Stanford type B dissection. This is the first report of a retrograde type A dissection after endovascular stent graft placement in Korea.
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