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1.
BMJ Case Rep ; 15(5)2022 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-35545309

RESUMO

We present a woman in her 60s diagnosed with an intermediate-high risk acute pulmonary embolism and a large, non-serpiginous right atrial (RA) mass. Conservative therapy with unfractionated heparin was started and further assessment of the mass with cardiac MRI suggested thrombus as the most likely diagnosis. Despite 1 month of anticoagulation, mass size remained stable and surgical RA embolectomy and left pulmonary endarterectomy was performed. Histopathology confirmed thrombus. The patient died 10 weeks after surgery.


Assuntos
Embolia Pulmonar , Trombose , Embolectomia , Feminino , Heparina , Humanos , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/cirurgia , Reperfusão , Trombose/cirurgia
2.
J Cardiothorac Surg ; 17(1): 95, 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35505355

RESUMO

BACKGROUND: The optimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism. CASE PRESENTATION: A 47-year-old male presented with weakness in his left arm upon awakening. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a mobile pedunculated object suggestive of a thrombus arising from the ascending aorta and extending to the left common carotid artery. It was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. Histopathological examination revealed that the object was a thrombus. The patient had an uneventful postoperative course and was discharged 9 days after surgery. CONCLUSION: When a thrombus in the aortic arch extends to the neck arteries, direct cannulation of the neck arteries with selective cerebral perfusion via cervical incision is a useful technique.


Assuntos
Tromboembolia , Trombose , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Artéria Carótida Primitiva/diagnóstico por imagem , Artéria Carótida Primitiva/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Perfusão/métodos , Trombose/diagnóstico por imagem , Trombose/cirurgia
3.
Oper Neurosurg (Hagerstown) ; 22(5): 277-283, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35426877

RESUMO

BACKGROUND: Self-expandable stents have been increasingly used for endovascular treatment of intracranial aneurysms. Because the usage of intracranial stents has increased overall, total numbers of complications associated with these devices have increased. Thrombosis, distortion, or incomplete opening of stents are potential complications that may result in occlusion of the parent artery. In such cases, removal of the stent (stentectomy) may be the only solution to avoid serious clinical consequences. OBJECTIVE: To investigate the feasibility and efficacy of a novel stentectomy technique for removal of thrombosed self-expandable stents. METHODS: A retrospective review was performed of patients who underwent the stentectomy procedure. Initial and follow-up imaging and clinical outcomes were assessed. Immediate postprocedural and follow-up clinical statuses were assessed using the modified Rankin scale. RESULTS: Seven patients were included in this study (mean age: 54.1 years). The stentectomy was successful in 6 of 7 patients (85.7%). Seven stents in 6 patients were successfully removed to treat the acute in-stent thrombosis that was resistant to alternative bail-out treatments. The removed stents were self-expandable braided in 2 patients, flow diverters in 2 patients, and laser cut open-cell stents in 2 patients. Stentectomy failed to retrieve a thrombosed braided stent in 1 patient. The modified Rankin scale score of all patients who underwent a success stentectomy was ≤1. CONCLUSION: The stentectomy procedure using the defined technique is feasible to retrieve thrombosed stents and effective to restore the blood flow. It can be considered a last resort option to treat acute in-stent thrombosis resistant to alternative bail-out treatments.


Assuntos
Procedimentos Endovasculares , Aneurisma Intracraniano , Trombose , Procedimentos Endovasculares/métodos , Estudos de Viabilidade , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Pessoa de Meia-Idade , Stents , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/cirurgia
4.
S Afr J Surg ; 60(1): 44-48, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35451269

RESUMO

BACKGROUND: Severe cardiac failure from mechanical mitral valve thrombosis due to poor warfarin control is a major cause of emergency redo mitral valve replacement (MVR) in South Africa. This study aimed to review the outcomes of redo MVR in patients presenting with mitral valve failure to a tertiary South African centre. METHODS: Retrospective chart review of patients undergoing redo MVR over a 10-year period (2005-2014). Patient demographics, aetiology of valve dysfunction, preoperative clinical assessment and outcomes were analysed. RESULTS: Sixty-four patients had 80 mitral valve procedures. The M:F ratio was 1:2.8 and the median age was 18 (IQR 14-28.5) and 25 (IQR 18-40) at initial surgery and at redo surgery, respectively. Median interval between original and redo MVRs was 47.5 (IQR 7.5-124) months. Rheumatic valve disease was the original pathology in 58 patients (90.6%). Fifty-two patients underwent a single redo MVR and 12 patients had multiple redo MVRs. Fifty-eight (72.5%) were emergency redo procedures. Prosthetic valve thrombosis was present in 73.8%. Ten patients (15.6%) developed postoperative complications. The median hospital stay and ICU stay were 19 (IQR 12-27.5) days and 4 (IQR 3-7) days, respectively. Two patients died in the postoperative period (3.1%). The mean patient follow-up was 42 months. Three patients died during follow-up. CONCLUSION: The majority of redo MVR procedures were undertaken as an emergency with valve thrombosis being the most common aetiology. The mortality rate was 3.1% and postoperative complication rate was 15.6%.


Assuntos
Doenças das Valvas Cardíacas , Implante de Prótese de Valva Cardíaca , Trombose , Adolescente , Doenças das Valvas Cardíacas/etiologia , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Valva Mitral/cirurgia , Complicações Pós-Operatórias/etiologia , Reoperação , Estudos Retrospectivos , África do Sul , Trombose/etiologia , Trombose/cirurgia , Resultado do Tratamento
5.
Vasc Endovascular Surg ; 56(4): 448-453, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35258356

RESUMO

BACKGROUND: Angiosarcoma is a rare subtype of malignant vascular tumours which has been only anecdotally described in patients submitted to lower limb revascularization. CASE PRESENTATION: This paper reports a patient previously submitted to a femoropopliteal bypass using autologous great saphenous vein (GSV). Nine years after the initial surgery, a primary angiosarcoma of the thrombosed vein graft was diagnosed, requiring en bloc surgical resection. Rampant metastatic spread was documented despite primary tumour surgical resection with a dismal outcome within months. CONCLUSIONS: Malignant transformation of autologous vein for lower limb revascularization is extremely rare and anecdotally described in the literature. It is a poorly studied complication with an aggressive behaviour. This report further reinforces the need for early recognition of this pathology.


Assuntos
Hemangiossarcoma , Trombose , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/cirurgia , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/cirurgia , Humanos , Isquemia/cirurgia , Artéria Poplítea/diagnóstico por imagem , Artéria Poplítea/cirurgia , Veia Safena/transplante , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/cirurgia , Resultado do Tratamento , Grau de Desobstrução Vascular
8.
J Card Surg ; 37(6): 1776-1778, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35294069

RESUMO

BACKGROUND: Cardiovascular diseases are the leading cause of morbidity and mortality in pregnant women. On the other hand, cardiac surgery is not so common for pregnant women. CASE REPORT: We present the case of a pregnant woman with diagnosed thrombosis of the mechanical aortic valve in the 12th gestational week. The patient underwent surgery, and successfully completed her pregnancy till the 37th gestational week. CONCLUSION: We showed that, despite general anaesthesia during the first trimester of pregnancy, the application of the nonpulsatile flow of extracorporeal circulation and mild hypothermia, the operation was successfully completed and that both mother and fetus survived.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Próteses Valvulares Cardíacas , Complicações Cardiovasculares na Gravidez , Trombose , Valva Aórtica/cirurgia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Feminino , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Gravidez , Complicações Cardiovasculares na Gravidez/etiologia , Complicações Cardiovasculares na Gravidez/cirurgia , Primeiro Trimestre da Gravidez , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/cirurgia
10.
Kyobu Geka ; 75(3): 203-207, 2022 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-35249954

RESUMO

No case report about takotsubo cardiomyopathy with Stanford type A acute dissection is present in the literature. Here we report a case of takotsubo cardiomyopathy that was diagnosed following Stanford type A acute aortic dissection. A 65-year-old man was admitted with dyspnea. He had experienced acute chest pain 10 days prior. Computed tomography (CT) confirmed Stanford type A aortic dissection and primary entry tear in the proximal aortic arch with a thrombosed false lumen in the ascending aorta. Echocardiography revealed takotsubo-like wall motion, with an ejection fraction (EF) of 20%. Electrocardiography (ECG) showed ST-segment elevation in V2-V3. Subsequently, coronary artery disease was excluded by coronary CT. After 1 month, ECG findings and EF appeared normal. Thirty-five days after admission, aortic arch replacement was performed with the frozen elephant trunk technique. The patient's postoperative course was uneventful. Takotsubo cardiomyopathy should be considered as a possible complication of acute aortic dissection with ST-segment elevation.


Assuntos
Aneurisma Dissecante , Aneurisma da Aorta Torácica , Implante de Prótese Vascular , Cardiomiopatia de Takotsubo , Trombose , Idoso , Aneurisma Dissecante/complicações , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/cirurgia , Aorta/cirurgia , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/complicações , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/métodos , Humanos , Masculino , Cardiomiopatia de Takotsubo/complicações , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Trombose/cirurgia
11.
Kyobu Geka ; 75(4): 312-315, 2022 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-35342164

RESUMO

An 81-year-old female underwent mitral valve plasty and tricuspid annuloplasty using an artificial annulus for mitral valve insufficiency and secondary tricuspid valve insufficiency at our hospital. Echocardiography 5 months later showed no abnormal finding. Eight months after the operation, however, a pedunculated and highly mobile mass in the right atrium was found, and the patient was admitted to our hospital. Its shape was really uncommon, and it was difficult to differentiate between a thrombus and a tumor. We subsequently performed a surgical removal. The resected mass was filled with many starshaped spherical tissues which were partially organized white thrombi histologically. Damage to the right atrial endocardium during previous surgery could be the cause.


Assuntos
Insuficiência da Valva Mitral , Trombose , Insuficiência da Valva Tricúspide , Idoso de 80 Anos ou mais , Feminino , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/cirurgia , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/cirurgia , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgia , Insuficiência da Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/etiologia , Insuficiência da Valva Tricúspide/cirurgia
12.
BMJ Case Rep ; 15(3)2022 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-35296494

RESUMO

Renal cell carcinoma (RCC) is the most aggressive urological malignancy, with a high recurrence rate. Despite the rapid evolution of the treatment of RCC from non-specific cytotoxic therapies to specific novel combination therapies, the general prognosis for advanced RCC remains poor because patients' responses to these therapies vary. Herein, we present the case of a male in early forties who was diagnosed with a right lower pole renal mass with a level IV tumour thrombus, which was later confirmed as stage IIIc clear cell RCC. About 19 months after radical nephrectomy (curative surgery), the patient was diagnosed with a biopsy-proven metastatic disease, which was not responsive to first-line treatment owing to insufficient data on the best treatment regimen. Herein, we also present a literature review on the pathological impact of genomic alterations in tumour suppressors and highlight emerging paradigm shifts in the treatment of RCC.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Trombose , Carcinoma de Células Renais/patologia , Humanos , Neoplasias Renais/patologia , Masculino , Nefrectomia , Prognóstico , Trombose/etiologia , Trombose/cirurgia
13.
J Oral Maxillofac Surg ; 80(5): 944-948, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35134375

RESUMO

PURPOSE: Since thrombosis is the leading cause of free flap failure, anticoagulant agents appear to improve free flap survival by decreasing the probability of thrombus formation. This retrospective study primarily aimed to evaluate the outcomes and complications of anterolateral thigh flap (ALT) transfer in patients who were postoperatively treated with or without low molecular weight heparin (LMWH) calcium. METHODS: This was a retrospective study. The sample comprised patients who underwent ALT transfer between January 2015 and January 2020 in the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital. The predictor variable was LMWH. The outcome variable was flap compromise. Other study variables were age, sex, defect location, hypertension, diabetes, number of vein anastomoses, alcohol history, radiation history, and hematoma. Descriptive, bivariate, and regression statistics were computed, and the P value was set at 0.05. RESULTS: The sample was composed of 2460 patients, comprising 2,234 males and 226 females, with a mean age of 50.5 years (range, 19-79 years). Based on the use of LMWH, the patients were divided into experimental and control groups. There were no significant differences in the clinical characteristics between the groups. Moreover, there were no significant differences in flap compromise or hematoma incidence between the groups. In the logistic regression model for flap compromise, the only factor found to be associated with flap compromise was hematoma (P < .0001). CONCLUSION: The use of LMWH in head and neck free flap transfer does not reduce the incidence of thrombosis and flap compromise.


Assuntos
Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço , Procedimentos Cirúrgicos Reconstrutivos , Trombose , Feminino , Retalhos de Tecido Biológico/irrigação sanguínea , Neoplasias de Cabeça e Pescoço/cirurgia , Hematoma , Heparina , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Coxa da Perna/cirurgia , Trombose/prevenção & controle , Trombose/cirurgia , Resultado do Tratamento
14.
Catheter Cardiovasc Interv ; 99(5): 1683-1686, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35170845

RESUMO

This case series explores four cases of thrombi straddling patent foramen ovale (TSFO), an exceedingly rare event. The cases are compared regarding their presentations, evaluations, and management strategies including the first documented uses of percutaneous thromboembolectomy for the removal of a TSFO.


Assuntos
Forame Oval Patente , Trombose , Forame Oval Patente/complicações , Forame Oval Patente/diagnóstico por imagem , Forame Oval Patente/terapia , Humanos , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/cirurgia , Resultado do Tratamento
16.
World J Surg Oncol ; 20(1): 36, 2022 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-35172849

RESUMO

BACKGROUND: Gastric cancer with portal vein tumor thrombus (PVTT) is poor prognosis, and the treatment remains challenging. Regarding surgery, there are only reports of highly invasive laparotomy. We report some techniques of the completely robotic total gastrectomy with thrombectomy and portal vein reconstruction for the patient with gastric cancer and PVTT for the first time. CASE PRESENTATION: A 79-year-old man was diagnosed with a 5-cm gastric cancer on the side of the lesser curvature from the middle of the gastric body to the cardia. Computed tomography revealed a massive PVTT extending from the left gastric vein to the portal trunk (28 x 16 mm). There were no other distant metastases. After 3 cycles of the chemotherapy, the PVTT shrank to 19 x 12 mm. After obtaining informed consent from the patient, robotic total gastrectomy with regional lymphadenectomy and thrombectomy were performed. We used the da Vinci Xi Surgical System. A 3-cm incision was made at the umbilicus, and a wound retractor was placed. Five additional ports were placed. The right side suprapancreatic lymph nodes were performed at the time of the thrombectomy. It was important to identify the precise extent of the PVTT with intraoperative ultrasonography before the thrombectomy. After PVTT identification, the portal trunk was clamped above and below the tumor thrombus with vascular clips. The membrane on the anterior wall of the portal trunk around the PVTT was carefully incised with da Vinci Scissors. The tumor thrombus was completely enucleated without separation. The incised part of the portal trunk was reconstructed with continuous 5-0 synthetic monofilament nonabsorbable polypropylene sutures. After removing the vascular clamps, we made sure there was no leakage from the portal vein and no tumor thrombus remnants with intraoperative ultrasonography. Robotic total gastrectomy with lymphadenectomy and Roux-en-Y reconstruction were performed. The patient was discharged without complications. The patient has remained alive for 30 months after surgery. CONCLUSIONS: Robotic total gastrectomy with thrombectomy and portal vein reconstruction is a safe, minimally invasive, and precise surgery. It may contribute to improved prognosis of gastric cancer with PVTT when combined with chemotherapy.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Procedimentos Cirúrgicos Robóticos , Neoplasias Gástricas , Trombose , Idoso , Carcinoma Hepatocelular/patologia , Gastrectomia/métodos , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Veia Porta/patologia , Veia Porta/cirurgia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Neoplasias Gástricas/complicações , Trombectomia , Trombose/cirurgia
18.
J Vet Intern Med ; 36(2): 441-450, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35129219

RESUMO

BACKGROUND: Aortic and aortoiliac thrombosis in dogs causes disease and death. OBJECTIVE: To describe the procedure and outcomes for stenting the caudal aorta and aortoiliac trifurcation. ANIMALS: Seven client-owned dogs that underwent aortic/aortoiliac stenting for treatment of thrombosis. METHODS: Retrospective multi-center investigation. Medical records were reviewed for dogs that underwent stenting of the aorta or aortoiliac trifurcation between 2008 and 2020. Information collected included history, signalment, clinicopathologic data, diagnostic imaging, procedure reports, and outcomes. RESULTS: Seven dogs with an occlusive thrombus located at or near the aortic trifurcation were included. Four of 7 dogs were non-ambulatory. Hind limbs were paretic in 5 dogs, paralyzed in 1 dog, and claudication alone was noted in 1 dog. Five of the 7 dogs had protein-losing nephropathy (PLN). Of 5 dogs with PLN, 1 had protein-losing enteropathy (PLE) and controlled hypothyroidism and 1 had caudal aortic chondrosarcoma. Two dogs had no identified underlying disease. Angiography was performed before catheter directed thrombolysis and stent placement. No deaths occurred during the procedure. Postoperative complications included pain (4/7), bruising and edema (3/7), bruising only (1/7), and edema only (1/7). Median survival time (MST) of the 7 dogs was 264 days (range, 1-1053 days). Five of 7 dogs were ambulatory within 2 days of stenting and survived to discharge with a MST of 425 days (range, 208-1053 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Stenting of the aorta and aortoiliac trifurcation can provide an apparently safe and effective treatment with rapid return to ambulation for some dogs with aortic thrombosis.


Assuntos
Doenças da Aorta , Doenças do Cão , Trombose , Animais , Aorta , Doenças da Aorta/cirurgia , Doenças da Aorta/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Estudos Retrospectivos , Stents/veterinária , Trombose/cirurgia , Trombose/veterinária , Resultado do Tratamento
19.
J Card Surg ; 37(4): 855-864, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35072279

RESUMO

BACKGROUND: The incidence of prosthetic tricuspid valve (TV) thrombosis is the highest among heart valves. It can lead to high morbidity and mortality without proper treatment. In this study, we sought to report the management and clinical outcomes of patients with mechanical TV thrombosis. METHODS: The current study was conducted in Rajaei Heart Center on 42 patients with mechanical TV thrombosis from 2006 to 2017. The baseline characteristics and the rates of adverse events during the follow-up period were assessed. RESULTS: A total of 67 episodes of mechanical TV thrombosis in 42 patients were observed. The mean age of patients was 45.5 ± 14.3 years (19-77), and overall two-thirds were female. Thrombolytic therapy was used in 41 (61.1%), anticoagulant intensification in 16 (23.9%), and surgery as the first approach in 10 (14.9%) episodes; subsequently, surgery as the final approach was implemented in 20 (29.8%) episodes. In-hospital mortality occurred in two (2.98%) patients. The rates of freedom from recurrent thrombosis were 84%, 61%, and 21% at the end of 1, 4, and 10 years, respectively. Survival rates and freedom from chronic valve dysfunction were 93%, 82%, and 75% after 1, 4, and 10 years. CONCLUSIONS: The results of the present study showed that recurrent thrombosis requiring intervention is a major complication of mechanical TV, which underscores individual-approached therapy and close follow-up.


Assuntos
Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Trombose , Adulto , Idoso , Feminino , Seguimentos , Próteses Valvulares Cardíacas/efeitos adversos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Trombolítica/efeitos adversos , Trombose/tratamento farmacológico , Trombose/etiologia , Trombose/cirurgia , Resultado do Tratamento , Valva Tricúspide/cirurgia , Adulto Jovem
20.
J Vasc Surg ; 75(6): 1864-1871.e3, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34995720

RESUMO

OBJECTIVE: Retrograde false lumen flow through distal entry tears poses a challenge in the treatment of chronic DeBakey IIIb aneurysms. In the present report, we have described the feasibility and outcomes of false lumen occlusion using an atrial septal occluder (ASO) in chronic DeBakey IIIb dissection associated with a descending aneurysm. METHODS: All the patients who had undergone thoracic endovascular aortic repair for chronic DeBakey IIIb aortic dissection at our institution from January 2014 to November 2020 were retrospectively reviewed. The primary endpoints were technical success and in-hospital postoperative results. The secondary endpoints included the midterm survival status and aortic remodeling outcomes. RESULTS: A total of 37 patients (age, 56.24 ± 10.47 years) with persistent retrograde false lumen perfusion and aneurysm formation at the thoracic segment were treated using an ASO for false lumen occlusion. We achieved 100% technical success. No spinal cord ischemia or in-hospital death was observed. The median follow-up time was 36 months (interquartile range, 24-51 months). After the procedure, three patients (8.1%) had had an endoleak (type Ia in two patients and type II in one patients), and five patients had required late reintervention. The overall 5-year survival rate was 71%. One aortic-related death (2.7% of the total cohort) occurred during follow-up at 9 months. Complete thrombosis of the false lumen along the treated aortic segment was recorded postoperatively in 34 patients (91.9%) at the final follow-up using computed tomography angiography. In a mixed-effects model, a diameter analysis revealed that the thoracic true lumen diameter had increased and the thoracic false lumen diameter had decreased significantly (0.256 mm/mo, P < .001; and -0.512 mm/mo, P < .001, respectively). CONCLUSIONS: The combination of standard thoracic endovascular aortic repair and false lumen occlusion using the ASO to promote false lumen thrombosis and remodeling in the treated segments is a technically feasible and effective alternative treatment of chronic DeBakey IIIb dissection with an associated descending aneurysm. This approach yielded satisfactory midterm survival outcomes and a low incidence of aortic-related death in our patients. However, further studies with more subjects and a prospective design should verify our findings before routine clinical implementation of this technique.


Assuntos
Aneurisma Dissecante , Aneurisma da Aorta Torácica , Implante de Prótese Vascular , Procedimentos Endovasculares , Dispositivo para Oclusão Septal , Trombose , Idoso , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/cirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/efeitos adversos , Mortalidade Hospitalar , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Stents , Trombose/cirurgia , Fatores de Tempo , Resultado do Tratamento , Remodelação Vascular
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