Endurant支架血管植入治疗腹主动脉瘤的经验  

Endurant stent-graft for the treatment of abdominal aorta aneurysm

作　　者：贾鑫[1] 郭伟[1] 刘小平[1] 熊江[1] 马晓辉[1] 张宏鹏[1] 杜昕[1] 张敏宏[1] 

机构地区：[1]中国人民解放军总医院血管外科,北京100853

出　　处：《中华普通外科杂志》2011年第11期904-906,共3页Chinese Journal of General Surgery

基　　金：首都医学发展科研基金资助项目（2007-1027）

摘　　要：目的评估新一代Endurant支架血管植入治疗腹主动脉瘤的近期临床结果。方法回顾性分析2010年7月至2011年6月收治的用Endurant支架血管治疗腹主动脉瘤68例患者的临床资料。其中男57例，女11例。术前ASA（ American Society of Anesthesiologists ）评分Ⅱ级15例，Ⅲ级32例，Ⅳ级21例。按照经典解剖形态学分析，本组有26例患者近端瘤颈不理想。结果13例破裂性腹主动脉瘤行急诊手术，其余55例为择期手术。手术技术成功率100％，平均手术时间（96±29）min，平均出血量（99±68）ml，对比剂平均用量（122±65）ml。术后即时造影显示有Ⅱ型内漏18例（26％），无中转手术、及Ⅰ或Ⅲ型内漏、及支架内血栓形成等并发症。术后反应综合征发生率为72％（49／68）。术后平均随访时间（8±5）个月，随访率为82．4％（56／68）。结论无论对于一般的还是有复杂解剖特点的腹主动脉瘤患者均可安全植入Endurant支架血管，近期疗效是满意的。Objective To evaluate early results of Endurant stent-graft in the treatment of abdominal aortic aneurysms （AAAs）. Methods From July 2010 to June 2011, 68 patients （57 men, 11 women; mean age 74.3 years） were treated with Endurant stent-graft at our center. 26 cases had hostile proximal neck in the anatomy. According to ASA classification, 15 cases were class H ; 32 cases were class m and 21 cases were class IV. Results Intraoperative immediate technical success was achieved in all cases. At completion angiography, a type 11 endoleak was detected in 18 （26%） of the 68 patients. The mean operation time was （96 ± 29） min, the mean blood loss was （99 ± 68 ） ml, and the mean contrast usage was （122 ± 65） ml. No intraoperative conversion to open surgery, stent migration, types I/III endoleak, other major complications, or death was encountered. 49 patients （72%） had a postimplantation syndrome with fever, leukocytosis, and increase of C-reactive protein levels, which completely resolved within two weeks. The mean follow-up time was （ 8 ± 5 ） months. Conclusions Endurant stent-graft seems to be safe and effective in endovascular aneurysm repair, even in patients with hostile aortoiliae anatomy.

关 键 词：主动脉瘤 腹 血管成形术 支架 

分 类 号：R654.3[医药卫生—外科学]