RESUMO
Approximately 6 months after the successful implantation of an abdominal aortic endovascular graft, a patient suffered an acute aortic dissection. The false lumen of the dissection terminated in the excluded aneurysm sac, resulting in a lack of outflow. Extreme true lumen compression eliminated blood flow within the distal aorta, resulting in the patient's demise.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Dissecção Aórtica/etiologia , Dissecção Aórtica/cirurgia , Implante de Prótese Vascular/efeitos adversos , Dissecção Aórtica/diagnóstico por imagem , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada EspiralRESUMO
The development of endovascular techniques has introduced a new dimension to the management of acute aortic dissection. Conventional therapy has traditionally been relegated to patients who experience severe clinical sequelae; unfortunately, clinicians have not been able to accurately predict the clinical consequences of a dissection. However, recent attention to true and false lumen characteristics, the distal extent of the dissection, and branch vessel involvement has demonstrated that these independent predictors of outcome can serve as surrogate indications for endovascular or surgical treatment. We review the pathophysiological mechanisms associated with the sequelae of aortic dissection and summarize the treatment paradigms we have developed.
