一体化单分支支架对部分主动脉弓部行腔内隔绝术  

Endovascular repair of the descending aorta and left subclavian artery by unifurcate stent graft in animal experiments

作　　者：林晨[1] 陆清声[2] 王烈[1] 黎成金[1] 景在平[2] 

机构地区：[1]南京军区福州总医院普通外科,福州350025 [2]第二军医大学附属长海医院血管外科暨全军血管外科研究所

出　　处：《中华实验外科杂志》2012年第1期58-60,共3页Chinese Journal of Experimental Surgery

基　　金：国家863高技术研究发展计划资助项目（2006AA0224-E2）;福建省自然科学基金资助项目（2011J05088）;上海市浦江人才计划（PJ200900907）;上海市科技启明星计划（09QA1407300）

摘　　要：目的设计制作新型一体化带单分支的主动脉腔内支架，以此种支架对动物行主动脉弓分支区腔内血管重建的实验，探讨其腔内重建主动脉弓的可行性。方法设计并制作适合于动物实验的一体化单分支覆膜支架，其分支针对左锁骨下动脉（LsA）；在x线透视引导下，对猪行主动脉弓腔内血管重建；术后第3个月观察支架形态结构、主动脉血流动力学变化及内漏发生状况。结果8例均完成支架的植入，平均手术时间（93．5±12．1）min；术后第3个月造影显示支架位置及形态良好，冠状动脉及分支动脉血流通畅，未发现支架贴壁不良的情况；头部CT未发现脑梗塞；支架植入后第3个月，LSA的血压为（138．0±8．8）mmHg（1minHg=0．133kPa），降主动脉的动脉压为（141．3±8．5）mmHg，与术前比较差异均无统计学意义（P〉0．05）；对支架周围的血管壁组织切片检查未发现血管内膜损伤。结论应用一体化单分支支架部分重建猪的主动脉弓在技术上可行，有助于探索腔内重建人体主动脉弓。Objective To design a novel unifurcate stent graft and evaluate the feasibility of endo- vascular repair in pigs using this stent graft for the descending aorta and the left subclavian artery （LSA）. Methods Unifurcate-covered stents were implanted in 8 pigs for the experiments by endovascnlar method, Arteriography, head computed tomography （CT） scans and animal autopsy were performed 3 months after the procedures. The pre- and postoperative arterial blood pressure in descending aorta and LSA in each animal was measured 3 months after stent graft deployment. Results Unifurcate stent graft was deployed successfully in each animal. The mean operation time was （93.5±12. 1 ）min. All animals survived for at least 3 months. The biological characters of the experimental animals were as usual. Arteriography and nec-ropsy revealed good fixation in all cases. None of the animals displayed backflow through the aortic valve, and their coronary ostia appeared uncompromised. The head CT scans found no lesion of cerebral infarction. The arterial pressure in LSA was （138.0±8.8） mm Hg （1 mm Hg=0. 133 kPa） and the arterial pressure in descending aorta was （ 141.3±8.5 ） mm Hg. There was no significant difference in arterial pressure in descending aorta and LSA before and after operation （ P 〉 0. 05 ）. The statistical results were not supposed to cause any serious ischaemia of the upper extremities. Conclusion Endovascular repair of the aortic arch by side branched stent graft system seems to be feasible and safe. Further studies are required before clinical application of this procedure.

关 键 词：支架 腔内隔绝 降主动脉 

分 类 号：R654.3[医药卫生—外科学]