Causes and treatment of intimo-intimal intussusception in endovascular repair of aortic dissecting aneurysms / 中华全科医师杂志

ABSTRACT

Objective Todiscuss the causes and treatment of intimo-intimal intussusception in endovascular repair of aortic dissecting aneurysms.Methods This retrospective study included 7 patients with intimo-intimal intussusception who underwent endovascular repair of aortic dissecting aneurysms from January 2017 to June 2018.There were 5 males and 2 females aged 34 to 64 years (mean 47.1 years),with a clinical course from 8 hours to 3 months.Six cases presented with acute chest pain and 1 had abdominal pain.Preoperative CTA was performed in all patients to confirm the diagnosis.Six patients received thoracic endovascular aortic repair (TEVAR) and 1 receivedfenestration.Results The endovascular repairs were successful without converting to open surgery in all patients.Pathological classifications were 1 type Ⅰ,5 type Ⅱ and 1 type Ⅲ.Four patients received another aortic stent at distal segment to cover the intimo-intimal intussusception and 1 patient at proximal site.One patients received another bare stent in the superior mesenteric artery,and 1 case received abdominal aortic stent implantation.Balloon was used in 2 cases to dilate the stenosis of aortic stents.The death occurred in 1 case at 3 days after surgery for metadata object description schema,and 1 patient needed continuous renal dialysis after discharge.The postoperative conditions (from 7 to 21 days) of other patients were normal without paraplegia,bowel necrosis,lower limb ischemia or arterial rupture.Conclusions The results indicate that the intimo-intimal intussusception in endovascular aortic dissecting aneurysms repair is rare and it is a severe complication.Re-endovascular aortic repair is a safe and reliable surgical approachbased on the type in early phase.