Uma disseção muito complicada: um caso clínico

Authors

DOI:

https://doi.org/10.48750/acv.500

Keywords:

Acute type B aortic dissection, Endovascular surgery, TEVAR, PETTICOAT

Abstract

INTRODUÇÃO: A disseção aórtica aguda tipo B (DAAB) é uma síndrome aórtica aguda que apresenta elevada taxa de mortalidade. Atualmente, na fase aguda, preconiza-se o tratamento médico nos casos de DAAB não complicada, ficando a cirurgia reservada para os casos de DAAB complicada (rutura, síndrome de malperfusão, dor/hipertensão ref ratária, expansão rápida ou progressão proximal/distal). A cirurgia endovascular, por apresentar taxas de morbi-mortalidade francamente inferiores à cirurgia aberta, está recomendada sempre que possível.

CASO CLÍNICO: Apresentamos um caso de DAAB complicada de falso aneurisma, rotura e malperfusão visceral, submetida de urgência a tratamento endovascular (TEVAR + PETTICOAT) e drenagem torácica. O pós-operatório foi complicado de AVC isquémico do hemisfério direito, com recuperação quase completa dos défices durante o internamento.

A angio-TC de controlo, aos 2 meses, mostrou exclusão do falso aneurisma, expansão do verdadeiro lúmen (com adequada perfusão das artérias viscerais) e trombose parcial do falso lúmen (exceto em focos de preenchimento retrógrado à custa de artérias lombares e intercostais).

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Published

2023-08-15

How to Cite

1.
Tavares C, Pinto V, Figueiredo A, Fidalgo H, Alves G, Garcia AC, Ferreira ME. Uma disseção muito complicada: um caso clínico. Angiol Cir Vasc [Internet]. 2023 Aug. 15 [cited 2024 Nov. 3];19(2):46-50. Available from: https://acvjournal.com/index.php/acv/article/view/500

Issue

Section

Clinical Case