Levent YILIK, Haydar YAŞA, Banu LAFCI, İbrahim ÖZSÖYLER, Ali GÜRBÜZ

Travmatik akut torasik aort diseksiyonunda endovasküler tedavi: Olgu sunumu

Akut travma sonrası oluşan aort diseksiyonları yüksek mortalite riski taşır. Stanford tip B aort diseksiyonlarında mortalite oranı %50-60 arasındadır. Ancak, endovasküler cerrahi onarım tekniklerindeki ilerlemeler sayesinde mortalite ve morbidite oranlarında ciddi bir azalma meydana gelmiştir. Trafik kazası geçiren 19 yaşındaki erkek hastada, kontrastlı spiral torakoabdominal bilgisayarlı tomografide sol subklavyan arterin hemen altından başlayarak 5 cm’lik bir segmenti tutan Stanford tip B diseksiyon saptandı. İnen aorttaki diseksiyon endovasküler stent greftle onarıldı. Aortografiyle diseke aortik segmentin tamamen kapatıldığı ve kaçak olmadığı izlendi. Hasta beşinci günde taburcu edildi. Ameliyat sonrasında, düz grafi ve kontrastlı spiral bilgisayarlı tomografiyle yapılan kontrollerde greft migrasyonuna veya endovasküler kaçağa rastlanmadı.

Endovascular therapy for traumatic acute thoracal aortic dissection: a case report

Acute post-traumatic descending aortic dissections present a high risk for mortality, being 50-60% following surgical repair of Stanford type B aortic dissections. However, improvements in endovascular surgical repair techniques have led to significant decreases in mortality and morbidity. A 19-year-old male patient was examined by contrast-enhanced spiral thoracoabdominal computed tomography (CT) following a traffic accident. A Stanford type B dissection was detected arising just below the subclavian artery and involving a 5- mm segment of the descending aorta. Endovascular stentgraft repair was performed. A control aortography demonstrated complete closure without any leakage. The patient was discharged on the fifth postoperative day. Control examinations with plain chest radiography and contrast-enhanced spiral CT showed no graft migration or leakage.

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