INCRAFT腹主动脉覆膜支架系统治疗腹主动脉瘤  

Endovascular Aortic Repair of Abdominal Aorta Aneurysm With INCRAFT Endograft System

作　　者：李清乐[1] 李文睿 张小明[1] 张韬[1] 李伟[1] 张学民[1] 焦洋[1] 蒋京军[1] Li Qingle;Li Wenrui;Zhang Xiaoming(Department of Vascular Surgery,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院血管外科,北京100044

出　　处：《中国微创外科杂志》2018年第12期1062-1065,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：国家自然科学基金(81570426)

摘　　要：目的探讨INCRAFT腹主动脉覆膜支架系统腔内修复治疗腹主动脉瘤的效果。方法回顾性分析2017年2月～2018年4月使用INCRAFT腹主动脉覆膜支架系统治疗腹主动脉瘤20例资料,其中18例存在超适应证的不良瘤颈因素。局麻强化手术15例,气管插管全麻手术5例。均采用预置缝合器的经皮腹主动脉腔内修复手术。结果技术成功率100%。1例术中腹主动脉近端夹层,保守观察;其余19例无围术期不良事件。术后随访6～20(12. 0±4. 6)月,1例术后15个月出现Ⅰb型内漏,再次腔内修复,其余19例无不良事件。生存分析显示免于再干预率为术后12个月100%,术后18个月85. 7%。结论 INCRAFT腹主动脉支架系统可用于不良瘤颈腹主动脉瘤腔内修复手术,近期效果显示良好的有效性和安全性。Objective To explore the results of endovascular aortic repair(EVAR)for abdominal aortic aneurysm(AAA)with the INCRAFT AAA Stent Graft System.Methods From February 2017 to April 2018,20 AAA patients received EVAR with INCRAFT stent graft.Their clinical data were retrospectively collected.Eighteen patients had hostile neck factors for EVAR.All the patients were treated with percutaneous EVAR with preloaded vascular closure devices under selected anesthesia(local anesthesia in 15 cases,and general anesthesia in 5 cases).Results The technical success rate was 100%.One patient had intraoperative iatrogenic aortic dissection(type B)and was untreated for its contained feature.The other 19 patients recovered and were discharged from hospital uneventfully.All the patients were under regular followups with an average period of(12.0±4.6)months(range,6-20 months).One patient developedⅠb endoleak at 15 months postoperation and was repaired with endovascular therapy.Estimated rates of freedom from reintervention with KaplanMeier analysis were 100%at 12 months and 85.7%at 18 months.Conclusion The INCRAFT Stent Graft System can be used in EVAR for AAA patients with hostile neck anatomy with acceptable shortterm safety and efficacy.

关 键 词：腹主动脉瘤 腔内修复手术 不良瘤颈 覆膜支架 

分 类 号：R654.3[医药卫生—外科学]