肾动脉平面以上主动脉病变的微创介入治疗  

Minimally invasive treatment for supra-renal abdominal aorta lesions

作　　者：谷涌泉[1] 张建[1] 汪忠镐[1] 李建新[1] 俞恒锡[1] 李学锋[1] 齐立行[1] 郭连瑞[1] 崔世军[1] 罗涛[1] 陈兵[1] 董宗俊[1] 

机构地区：[1]首都医科大学宣武医院血管外科首都医科大学血管外科研究所,北京100053

出　　处：《中华普通外科杂志》2005年第11期698-700,共3页Chinese Journal of General Surgery

摘　　要：目的总结肾动脉平面以上主动脉疾病的微创介入治疗经验。方法回顾性分析2000年7月至2004年12月采用微创介入治疗的42例肾动脉平面以上主动脉疾病患者的临床资料。夹层动脉瘤32例,真性动脉瘤7例,假性动脉瘤3例。结果本组死亡1例(2.4%),术后第8天死于心源性猝死。无截瘫、偏瘫或卒中发生。即时内漏发生8例,占19.1%,其中2例放置带膜支架后内漏消失;3例较严重内漏经大球囊适当扩张后消失;另外3例由于范围不大,未行特殊处理。随访41例,随访时间1～48个月,平均为16个月。死亡1例,占2.5%。剩余的3例内漏全部消失,假腔内血栓形成。结论血管腔内微创介入技术治疗高风险的肾动脉平面以上主动脉疾病是相对安全、有效的方法,但远期疗效尚待进一步观察。Objective To evaluate endoluminal stent-grafting for diseases of supra-renal abdominal aorta. Methods We retrospectively analyzed the clinical data of 42 cases with supra-renal aorta lesions from July 2000 to December 2004, including 32 cases of dissection aorta aneurysm, 7 cases of thoracic aortic aneurysm, and 3 cases of thoracic pseudoaneurysm. Results One died in perioperative period （2.4%）. Endoleaks occurred in 8 cases （19. 1% ） after the deployment of the first stent. Among them, leaks were sealed in 3 cases by balloon dilatation, the remaining 2 cases were treated by the placement of additional stenting-graft, 3 cases were treated conservatively. Patients were followed-up for 1 ～ 51 months, with a mean of 16 months. One （2.4%） died during the follow-up. Endoleak disappeared in 3 eases. Conclusion Minimally invasive endoluminal grafting is a relatively safe and effective means for the treatment of high-risk aortic lesions, though the long-term result remains to be proved.

关 键 词：动脉瘤 夹层 动脉瘤 假 带膜支架 

分 类 号：R654.3[医药卫生—外科学]