腔内覆膜支架置放修复周围动脉损伤  

Endovascular covered stent-graft repair of traumatic arterial lesions

作　　者：杨宏宇[1] 章希炜[1] 孙蓬[1] 邹君杰[1] 董剑[1] 

机构地区：[1]南京医科大学第一附属医院血管外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2006年第7期538-539,566,共3页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:探讨腔内覆膜支架置放修复周围动脉损伤的适应证。评估腔内覆膜支架置放修复周围动脉损伤的可行性及疗效。方法:回顾2004年5月至2006年1月,6例行腔内覆膜支架置放术的周围动脉损伤患者之临床资料。肾动脉损伤(假性动脉瘤)1例,髂总动脉损伤(假性动脉瘤伴动静脉瘘、局灶性穿通伤)2例,股动脉损伤(均为假性动脉瘤)2例,股浅动脉损伤(假性动脉瘤)1例。其中穿通性损伤4例(医源性3例、刀刺伤1例),钝性损伤2例。结果:所有患者均取得技术成功,损伤血管均被完全隔绝。除1例肾动脉损伤患者发生内漏外,某余术后随访2～18个月,肾动脉支架内漏1个月后消失。所有患者未发现支架内严重再狭窄(>50%)。结论:腔内覆膜支架置放治疗周围动脉损伤是安全、可行的,在严格而准确地掌握适应证的基础上,施行血管腔内覆膜支架置放术治疗周围动脉损伤,具有较传统手术创伤小、安全性高及恢复快的优点。Objective： To investigate the feasibility, efficacy and indications of endovascular covered stent-graft in repairing trau- matic arterial lesions. Methods： Patients with blunt or penetrating （including iatrogenic） peripheral arterial injuries between May 2004 and January 2006 were retrospectively studied.Endovascular covered stent-graft repair of peripheral arterial lesions was performed in 6 patients, including one case of renal pseudnaneurysm,one iliac pseudoaneurysm and arteriovenous fistulas,one iliac focal laceration,two common femoral, pseudoaneurysms and one superficial femoral pseudoaneurysm. Results. All cases were technically successful. Completion arterlography revealed complete exclusion of all lesions,except for one minimal proximal stented graft leak in the renal pseudoaneurysm.All patients eontinued to have patent grafts with a follow-up ranging from 2 to 18 months （mean 8.5 months ）.The proximal leak initially present in a stented graft vanished after 1 month. Conclusion： Endovascular covered stent-grafts offer an effective,feasible and less invasive technique in treating traumatic arterial lesions on the basis of accurately defining the management indications.

关 键 词：血管损伤 覆膜支架 腔内修复 

分 类 号：R654.4[医药卫生—外科学]