应用NuMED CP覆膜支架治疗成人主动脉缩窄  

Application of the NuMED covered CP stent in treatment of adult coarctation of the aorta

作　　者：赵昌学[1] 宋艳苹[2] 冯冗 

机构地区：[1]菏泽市立医院心脏血管外科,山东菏泽274000 [2]菏泽医学专科学校

出　　处：《中国介入心脏病学杂志》2017年第4期206-209,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的评价NuMED CP覆膜支架治疗成人主动脉缩窄的临床效果。方法对6例主动脉缩窄患者行NuMED CP覆膜支架置入术,男4例,女2例,平均年龄(20.13±5.16)岁。根据术前行主动脉CT血管造影(CT angiography,CTA)检查选择合适型号的支架和球囊;经股动脉穿刺送入装载有支架的球囊导管,准确定位后充盈内、外球囊,扩张覆膜支架。术毕应用血管缝合器缝合血管穿刺点。结果 6例患者均成功置入NuMED CP覆膜支架。导管测得跨缩窄段压差由术前(59.32±15.78)mm Hg(1 mm Hg=0.133 k Pa)下降至(10.83±3.66)mm Hg(P<0.001),主动脉缩窄最窄处直径由术前(5.1±1.2)mm增加至(19.7±2.4)mm(P<0.001)。2例合并动脉导管未闭患者,分流完全消失,上下肢血压恢复正常。患者术后随访12~36个月,活动后心慌、四肢乏力症状明显缓解。6例患者血压均正常,停服降压药物,无剧烈活动后胸闷和头痛、头晕等症状。术后3个月行多普勒超声或胸主动脉CTA检查,主动脉缩窄段直径明显改善,无死亡病例。结论 NuMED CP覆膜支架对治疗成人主动脉缩窄的近期疗效满意,远期疗效有待进一步观察。Objective To evaluate the NuMED covered CP stent for the treatment of adult aortic coarctation. Methods 6 patients with coarctation of the aorta received covered CP stent implantation. There were 4 males and 2 females cases with mean age of （20. 13 ±5.16） years old. The size of the covered CP stents and balloons were determined by preoperative aortic CTA assessment. Stent implantation was per formed through femoral approach and the puncture site was sealed by vascular closure device after the operation. Results All the NuMED covered CP stents were implanted successfully. The pressure gradient dropped from （59. 32 ± 15.78） mmHg to （ 10. 83 ±3.66） mmHg （P 〈0. 001 ） after stenting. The diameter of the coarcation at the narrowest point increased from preoperative （ 5. 1 ± 1.2 ） mm to （ 19. 7 ± 2.4 ） mm after stenting （ P 〈 0. 001 ）. In 2 cases with PDA, the shunting disappeared spontaneously after operation with normalized of lower limb blood pressure. All the patients were followed up clinically for 12 - 36 months and all of them reported improvement in clinical symptoms post operation. Follow up Doppler echo or aorta CTA examinations at 3 months showed no restenosis. No mortality recorded during follow up. Conclusions NuMED covered CP stent for the treatment of aortic coarctation in adults showed satispactony short term outcome. Its long term outcome still requires further in vestigation.

关 键 词：主动脉缩窄 NuMED CP覆膜支架 介入治疗 

分 类 号：R543.1[医药卫生—心血管疾病]