聚四氟乙烯覆膜支架在外周动脉瘤腔内治疗中的应用  

Endovascular exclusion of peripheral aneurysms with polytetrafluoroethene stent graft

作　　者：徐欣[1] 杨珏[1] 竺梃[1] 岳嘉宁[1] 李永生[1] 侯凯[1] 毛荣富[1] 王玉琦[1] 符伟国[1] 

机构地区：[1]复旦大学附属中山医院血管外科,上海200032

出　　处：《中华外科杂志》2014年第8期597-601,共5页Chinese Journal of Surgery

摘　　要：目的 探讨采用聚四氟乙烯（PTFE）覆膜支架腔内治疗外周动脉瘤的疗效.方法 收集2012年5月至2013年11月收治的13例采用PTFE覆膜支架行腔内修复治疗的外周动脉瘤患者的临床资料,其中男性9例,女性4例,年龄24 - 74岁,中位年龄52岁.患者包括颈内动脉假性动脉瘤1例,锁骨下真性动脉瘤2例,内脏动脉瘤4例,髂动脉瘤2例,股动脉瘤4例;真性动脉瘤7例,假性动脉瘤6例.结果 13例患者腔内修复术即时疗效满意,数字减影血管造影显示动脉瘤瘤腔消失,远端动脉搏动正常.术后随访3 -18个月,1例髂外动脉瘤术后3个月出现股动脉穿刺点假性动脉瘤,予以手术修复,其余病例未见手术并发症,外周动脉瘤消失,支架通畅,远端肢体或脏器动脉无栓塞,供血正常.结论 采用PTFE覆膜支架对外周动脉瘤进行腔内修复术,创伤小,能有效治疗外周动脉瘤.Objective To evaluate the value and clinical effect of peripheral aneurysms with polytetrafluoroethene （PTFE） stent graft after peripheral endovascular procedures.Methods From May 2012 to November 2013,13 patients of peripheral aneurysms were treated with PTFE stent graft.There were 9 male and 4 female patients,aged from 24 to 74 years with a mean of 52 years.There were 7 aneurysms and 6 pseudoaneurysms.This stent graft was a self-expanding nitinol stent,internally covered by an ultra-thin polytetrafluoroethene （PTFE） graft.All peripheral aneurysms were repaired with the PTFE stent graft,using an entirely percutaneous approach.All patients were given clopidogrel and （or） aspirin postoperatively.Complications and reintervention rates were also examined.Results PTFE stent graft placement was successfully performed in all the 13 cases,and the instant isolation effect was quite satisfactory.During the follow-up period of 3 to 18 months,no stent graft related complications occurred in all patients except one patient with iliac arterial pseudoaneurysm,who developed pseudoaneurysms presented as a complication at puncture site.There were no other symptomatic complications with graft patience.Conclusion Endovascular repair can be considered as an effective treatment strategy for peripheral aneurysms by PTFE stent graft.

关 键 词：动脉瘤 动脉瘤 假性 动脉瘤 感染性 支架 

分 类 号：R732.21[医药卫生—肿瘤]