JACC. Case reports · 2026
Timely Carotid Revascularization to Prevent Stroke After Left Common Carotid Artery Occlusion During TEVAR.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Setiadi Iman, Adiarto Suko
Аннотация
BACKGROUND: Proximal thoracic endovascular aortic repair extension near the aortic arch may compromise supra-aortic branch perfusion.
CASE SUMMARY: A 41-year-old man with acute Stanford type B/DeBakey III aortic dissection had persistent chest pain despite anti-impulse therapy. A persistent type IA endoleak after the first thoracic stent graft required a second proximal extension. Completion angiography showed resolution of the endoleak but immediate loss of left common carotid artery opacification. Carotid duplex ultrasonography confirmed absent flow. Ultrasound-guided direct left common carotid artery access followed by chimney stenting restored antegrade carotid flow within 10 minutes, before any neurologic deficits developed.
DISCUSSION: Immediate recognition and rapid bailout revascularization can prevent disabling cerebral ischemia after inadvertent left common carotid artery compromise.
TAKE-HOME MESSAGE: Supra-aortic branch patency should be confirmed after proximal thoracic endovascular aortic repair extension, with prompt carotid bailout when compromise is detected.
CASE SUMMARY: A 41-year-old man with acute Stanford type B/DeBakey III aortic dissection had persistent chest pain despite anti-impulse therapy. A persistent type IA endoleak after the first thoracic stent graft required a second proximal extension. Completion angiography showed resolution of the endoleak but immediate loss of left common carotid artery opacification. Carotid duplex ultrasonography confirmed absent flow. Ultrasound-guided direct left common carotid artery access followed by chimney stenting restored antegrade carotid flow within 10 minutes, before any neurologic deficits developed.
DISCUSSION: Immediate recognition and rapid bailout revascularization can prevent disabling cerebral ischemia after inadvertent left common carotid artery compromise.
TAKE-HOME MESSAGE: Supra-aortic branch patency should be confirmed after proximal thoracic endovascular aortic repair extension, with prompt carotid bailout when compromise is detected.