Modified Perfusion Strategy and Aortic Arch Debranching in Complicated Acute Aortic Dissection Type A: A Bridge to Definitive Endovascular Therapy

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概要

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• Introduction: Patients with acute aortic dissection type A (AADA) with aortic arch and supra-aortic vessel involvement have a higher postoperative stroke prevalence and risk of later aortic arch aneurysm development.Case Report: We report a case of AADA with involvement of supraaortic arteries, complicated by cerebral malperfusion. The ascending aorta was replaced using bilateral antegrade cerebral perfusion through side-grafts attached to both carotid arteries, which were subsequently used as aorto-bi-carotid bypass. One year later, the diameter of aortic arch increased to 5 cm. The endovascular treatment of aortic arch was easily performed since debranching was already almost complete.Conclusions: Immediate bilateral carotid artery inflow and subsequent aorto-bi-carotid bypass is a safe way to prevent cerebral malperfusion in the setting of complicated AADA.A potential benefit of this technique is almost complete debranching that facilitates an endovascular arch replacement.

著者

• Blanke Philipp

  Department Of Diagnostic Radiology University Hospital Freiburg

• Beyersdorf Friedhelm

  Heart Center Freiburg University, Freiburg, Germany

• Siepe Matthias

  Heart Center Freiburg University, Freiburg, Germany

• Rylski Bartosz

  Heart Center Freiburg University, Freiburg, Germany

• Kari Fabian

  Heart Center Freiburg University, Freiburg, Germany

• Schoellhorn Joachim

  Heart Center Freiburg University, Freiburg, Germany

関連論文

• Adventitial Inversion with Graft Telescopic Insertion for Distal Anastomosis in Acute Type A Aortic Dissection
• Modified Perfusion Strategy and Aortic Arch Debranching in Complicated Acute Aortic Dissection Type A: A Bridge to Definitive Endovascular Therapy

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