The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Thoracic Endovascular Aortic Repair of a Penetrating Aortic Ulcer in the Thoracic Aorta Combined with an Abdominal Aortic Aneurysm

복부 대동맥류가 동반된 흉부 대동맥 침투성 궤양의 혈관 스텐트 치료 1예

  • Kim, Bo-Won (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Ha, Dong-Woo (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Bae, Min-Jung (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Choi, Jin-Hee (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Kim, Hae-Kyu (Department of Anesthesiology, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Lee, Chung-Won (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Lee, Han-Cheol (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine)
  • 김보원 (부산대학교 의학전문대학원 부산대학교병원 내과) ;
  • 하동우 (부산대학교 의학전문대학원 부산대학교병원 내과) ;
  • 배민정 (부산대학교 의학전문대학원 부산대학교병원 내과) ;
  • 최진희 (부산대학교 의학전문대학원 부산대학교병원 내과) ;
  • 김해규 (부산대학교 의학전문대학원 부산대학교병원 마취과) ;
  • 이충원 (부산대학교 의학전문대학원 부산대학교병원 흉부외과) ;
  • 이한철 (부산대학교 의학전문대학원 부산대학교병원 내과)
  • Published : 2012.04.01
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Abstract

Penetrating aortic ulcers (PAUs) are part of acute aortic syndrome and can cause aortic rupture. We report a case of abdominal aortic aneurysm (AAA) with a PAU in the thoracic aorta. The patient was treated with thoracic aortic endovascular repair (TEVAR) for the PAU and open repair for the AAA. A 78-year-old man was admitted due to abdominal discomfort. Computed tomography (CT) showed a 6.8-cm AAA with a short neck and a large (4.2 ${\times}$ 3.3 cm) thoracic PAU. The patient was scheduled for AAA repair. Due to the risk of rupture of the thoracic PAU, TEVAR was performed in the PAU before surgery for the AAA. After stent graft insertion, the patient underwent surgery to repair the AAA. A follow-up CT scan showed no endoleakage or thrombus formation in the PAU. The patient had no specific symptoms during 1 year of follow-up.

침투성 동맥 경화성 궤양은 급성 대동맥 증후군의 일부로 대동맥의 파열 위험이 증가하는 질환이다. 침투성 동맥 경화성 궤양 환자에게 있어서 증상이 지속되거나 점차 크기가 증가하여 파열의 위험이 있을 때 수술적 치료 또는 혈관 내 스텐트 이식편 삽입 시술이 필요하다. 본 증례는 78세 남자 환자가 복부 불편감을 주소로 내원하여 수술적 치료가 필요한 복부 대동맥류가 진단되었으며 이에 동반된 큰 크기의 침투성 동맥 경화성 궤양이 관찰된 환자이다. 수술 전 침투성 동맥 경화성 궤양에 대하여 혈관 내 스텐트 이식편 삽입하였고 이후 복부 대동맥류에 대하여 수술적 치료를 시행하여 성공적으로 환자를 치료한 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

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