A Case of TEVAR for Ruptured Chronic Type B Thoraco-abdominal Aneurysm

DOI
  • Ohyama Noriko
    Department of Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center
  • Abe Noriyuki
    Department of Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center
  • Yamazato Takahiro
    Department of Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center
  • Kinoshita Ryo
    Department of Radiology, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center
  • Ganaha Fumikiyo
    Department of Radiology, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center
  • Munakata Hiroshi
    Department of Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center

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Other Title
  • 慢性解離性胸腹部大動脈瘤破裂に対してTEVARを施行した一例

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<p>A 71-year-old woman presented with severe chest pain persisted for one week. Her medical history included Stanford type B aortic dissection 10 years prior, obesity hypoventilation syndrome and chronic renal failure. CT revealed a diagnosis of ruptured post dissection thoraco-abdominal aortic aneurysm (TAAA). Because of the respiratory insufficiency, we abandoned open surgery and endovascular repair was performed. First, the primary entry tear was closed by TEVAR, and then the major re-entry tear at the site of detached right renal artery was closed using a covered stent bridged from the aortic true lumen to the right renal artery. There still remained false lumen backflow through another re-entry tear at detached intercostal artery, and we embolized false lumen with NBCA-Lipiodol. The false lumen was completely thrombosed, and remained nonrecanalized at one year follow-up.</p>

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