Aortic remodeling and competitive flow after surgical treatment of aortic dissection

Journal of Vascular Surgery Cases and Innovative Techniques

Abeel A. Mangi, MD, MBA¹  John Elefteriades, MD¹  Jonathan A. Cardella, MD²  Anand Brahmandam, MD²  Cassius Iyad Ochoa Chaar, MD, MS²  John F. Setaro, MD³  Shin Mei Chan, BS⁴ 

[1] Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn;Division of Vascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn;Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn;Yale University School of Medicine, New Haven, Conn;

关键词: Acute limb ischemia;    Aortic dissection;    Axillobifemoral bypass;    Extra-anatomic bypass;    Malperfusion;    Recanalization;   

DOI  :  

来源: DOAJ

【 摘 要 】

Aortic remodeling after dissection is poorly understood and remains a focus of current research. In the present report, we have described the cases of two patients with acute lower extremity ischemia related to malperfusion from aortic dissection treated with extra-anatomic axillobifemoral bypass. During long-term follow-up, aortic remodeling led to reinstitution of flow through the native aorta. This resulted in competitive flow, leading to complete thrombosis of the extra-anatomic conduits. These cases highlight the occurrence of spontaneous aortic recanalization and subsequent competitive flow, two vascular phenomena that are not well understood but can significantly affect patient outcomes.

【 授权许可】

Unknown